Duplicate bladder exstrophy: A case report

Abstract

A newborn male presented with what appeared to be classic bladder exstrophy. He had a well-formed penis with an epispadiac urethral plate. Inability to identify the ureteral orifices during surgical repair led to the discovery of a normally positioned external urethral meatus joining a closed bladder posterior to the exstrophic one. The closed bladder had a thin distensible wall into which both ureteric orifices opened. There was divergence of the recti and diastases of the pelvic bones. As the only muscular component was the exstrophic wall, it was decided to excise an elliptical strip of the muscular wall in the midline and establish a communication between the two bladders. The exstrophic wall was then closed, converting the two bladders into one shared cavity, and the urethral plate was tubularized to construct a new urethra. The cosmetic result was acceptable and the child has normal control of urine from the normally positioned urethra.