Inferior Vesical Fissure-A Rare Variant of Exstrophy Bladder: Case Report With Literature Review

Area of Science:

• Pediatric Surgery
• Urology
• Developmental Biology

Background:

• Exstrophy variants are rare bladder anomalies, with bladder neck involvement being extremely uncommon.
• Inferior vesical fissure (IVF) is a rare exstrophy variant with only three prior case reports, typically associated with other malformations.
• The combination of inferior vesical fistula (IVF), urethral atresia, and anorectal malformation has not been previously documented.

Approach:

• This report details the management of a 4-year-old male with a previously operated anorectal malformation presenting with inferior vesical fissure.
• The treatment involved fistula closure and bladder neck reconstruction, including a lay open procedure for a stenosed urethra.
• Surgical intervention aimed to address the complex congenital anomalies.

Key Points:

• A rare case of inferior vesical fissure (IVF) is presented in conjunction with urethral atresia and anorectal malformation.
• The patient underwent successful surgical repair involving fistula closure and bladder neck reconstruction.
• This unique combination of anomalies required a tailored surgical approach.

Conclusions:

• Accurate recognition of exstrophy variants like IVF is crucial for effective treatment and improved patient outcomes.
• The described case expands the understanding of rare congenital anomalies involving the bladder and lower urinary tract.
• Prompt diagnosis and appropriate surgical management are essential for managing complex cases of bladder exstrophy variants.