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. 2008 Apr;13(2):57-60.
doi: 10.4103/0971-9261.43017.

Embryogenesis of bladder exstrophy: A new hypothesis

Bharati Kulkarni  1 , Navin Chaudhari
Affiliations

Embryogenesis of bladder exstrophy: A new hypothesis

Bharati Kulkarni et al. J Indian Assoc Pediatr Surg. 2008 Apr.

Abstract

Aims and objective: To postulate a hypothesis to explain the embryogenesis of exstrophy bladder based on our clinical observations.

Materials and methods: In 27 cases of exstrophy, we measured the distance between the lowermost inguinal skin crease to the root of the penis (clitoris) (B) and the distance between the penis (clitoris) and the scrotum (labia majora) (C). These were compared with age, height and XP distance (distance between xiphisternum and symphysis pubis) matched control group of normal children. The distance between the lowermost inguinal skin crease and the penis (clitoris) (A) was measured in control group.

Results: The observation was A = B + C. This implies that in exstrophy bladder, the position of the penis (clitoris) has moved cephalad from the lower border of A to the junction of B and C.

Conclusion: Based on the observations, we postulate that abnormal origin of genital tubercle may be the cause of exstrophy bladder. The abnormal origin of primordia of the genital tubercle in more cephalad direction than normal causes wedge effect, which will interfere with the medial migration of the mesoderm as well as the midline approximation of mesodermal structures in the lower abdominal wall, thereby resulting in the exstrophy of bladder.

Keywords: Bladder exstrophy; embryology of cloaca; genital tubercle.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Distance between the lowest inguinal skin crease and the root of penis. Distance between the root of penis and the upper border of scrotum
Figure 2
Figure 2
Distance between the lowest inguinal skin crease and penis
See this image and copyright information in PMC

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