Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 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.

PubMed Disclaimer

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

References

    1. Arey LB. Developmental anatomy. 6th ed. Philadelphia: W.B. Saunders Co; 1954. pp. 200–1.pp. 306–8.
    1. Jordan HE, Kindred JE. A text book of embryology. New York: Applleton and Co; 1932. pp. 116–8.
    1. Patten BM. Varying developmental mechanism in teratology. Paediatric. 1957;1:734–48. - PubMed
    1. Stockard CR. Developmental rate and structural expression and experimental study of twins double monsters and single deformities and the interaction among embryonic organs during their origin and development. Am J Anat. 1921;28:112–277.
    1. Porter RM. Bladder outside the belly. Nashville J Med And Surg. 1855;8:381.