Exstrophy of the Cloaca

Terminal Myelocystocele: A Series of 30 Cases and Review of the Literature

“…Similar findings have been described in other series as well; the size of the mass may be variable [2,6,10]. The overlying skin may exhibit a hemangioma, nevus or hypertrichosis.…”

“…A disruption of caudal motor segments can cause motor weakness, and an association of the caudal cell mass with the progenitor cells of the hindgut and urogenital system is responsible for the frequent association of urogenital anomalies with this defect [6]. Hayden et al [10] describe 2 cases of terminal myelocystocele associated with exstrophy of the cloaca. Schmitt and Kawakami [8] also report on similar cases, but surprisingly, none of our patients had similar associated anomalies, except for 1 patient who had an accessory phallus.…”

Pelvic kidney in cloacal exstrophy

“…Although not emphasized, other reports of cloacal exstrophy patients have mentioned patients with pelvic kidneys [4][5][6][7][8]. We feel that this association is probably not rare.…”

Severe lower limb defects in exstrophy of the cloaca

“…To determine the accuracy of this statement, we reviewed the literature on exstrophy of the cloaca for lower limb defects. Of 178 reviewed cases, including the one we presented here, 63 reportedly had normal lower limbs [Hurwitz et al, 1987;Meglin et al, 1990;Evans et al, 1994;Chen et al, 1997;Liang et al, 1998;Mathews et al, 1998;Hamada et al, 1999;Keppler-Noreuil, 2001;Reddy et al, 2003], 43 gave no information about the status of the lower limbs [Hayden et al, 1973;Diamond and Jeffs, 1985;Fujiyoshi et al, 1987;McLaughlin et al, 1995;Meizner et al, 1995;Pinette et al, 1996;Kano and Ichimura, 1997;Austin et al, 1998;Nye et al, 2000], 17 had clubfeet with no further status of the lower limb given [Diamond and Jeffs, 1985;Zarabi and Rupani, 1986;Fujiyoshi et al, 1987;McLaughlin et al, 1995;Robin et al, 1996;Bruch et al, 1996;Pinette et al, 1996;Girz et al, 1998;Silver et al, 1999], 24 had clubfeet as the only lower limb anomaly [Hurwitz et al, 1987;Meglin et al, 1990;Chen et al, 1997;Liang et al, 1998;Mathews et al, 1998;Keppler-Noreuil, 2001], and 31 had major malformations of the lower limbs [Ogden, 1976;Balog and Skinner, 1984;Hurwitz et al, 1987;Meglin et al, 1990;…”