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Bladder duplication with one exstrophy and one cloaca.

N R Feins, W Cranley

    Journal of Pediatric Surgery
    |July 1, 1986
    PubMed
    Summary
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    Bladder duplication is a rare congenital anomaly. This case highlights its varied presentation, emphasizing the need for thorough investigation in complex genitourinary abnormalities.

    Area of Science:

    • Urology
    • Pediatric Surgery
    • Medical Genetics

    Background:

    • Bladder duplication is an exceedingly rare congenital anomaly, with fewer than 100 cases documented.
    • Previous descriptions categorize bladder duplication as either mirror-image or septate.
    • Complex congenital anomalies often present diagnostic challenges.

    Observation:

    • A newborn female presented with a complex set of malformations including apparent bladder exstrophy, omphalocele, imperforate anus, and bifid clitoris.
    • Urine was observed exiting from multiple aberrant sites, including the bladder mucosa, a mucous fistula, and the hemiclitoris.
    • Initial presentation suggested bladder exstrophy, complicating the diagnostic process.

    Findings:

    • Multidisciplinary investigations revealed the underlying anomaly to be a complex bladder duplication.

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  • The presentation included an exstrophied anterior bladder, an intra-abdominal cloacal bladder, and a phallic urethra within the hemiclitoris.
  • This unique configuration presented a significant anatomical puzzle.

    • Implications:

    • This case underscores that bladder duplication can manifest in highly atypical and varied ways.
    • Accurate diagnosis of complex bladder duplication is crucial for appropriate surgical planning and intervention.
    • Successful surgical correction achieved normal function, demonstrating the possibility of managing even rare and complex presentations.