ABSTRACT
This chapter discusses management of the newborn with classic bladder exstrophy (CBE) based on the authors' experience and data derived from more than 1250 patients with bladder exstrophy, epispadias, and cloacal exstrophy from an institutionally approved database at the authors' institution. Currently, several techniques exist to reconstruct the newborn with bladder exstrophy. Bladder exstrophy, cloacal exstrophy, and epispadias are variants of the exstrophy-epispadias complex. The etiology of this complex has been attributed by Muecke to the failure of the cloacal membrane to be reinforced by ingrowth of the mesoderm. Exstrophy of the bladder is part of a spectrum of anomalies involving the urinary tract, genital tract, musculoskeletal system, and sometimes the intestinal tract. Patients with CBE have a characteristic widening of the pubic symphysis caused by malrotation of the innominate bones, in relation to the sagittal plane of the body along both sacroiliac joints.
