Pelvic development in the rabbit embryo: implications in the organogenesis of bladder exstrophy

Abstract

Current theses of the development of bladder exstrophy and its variants rely on defective evolution of the urinary tract and cloacal membrane. They do not account satisfactorily for the clinical features reported in children affected by exstrophy, especially the pelvic bone anomaly. We herein describe the normal development of the pelvic ring in the rabbit embryo and its chronological relationship with the lower urinary tract organogenesis. Our results suggest that these events are intricated and allow us to propose a novel mechanism to explain exstrophies.

Contemporary Epidemiology of Bladder Exstrophy in the United States

“…However, since many researchers believe that bladder exstrophy and cloacal exstrophy are related entities on a spectrum of malformation, inclusion of these patients would not be without justification. 14,15 Moreover, as the incidence of cloacal exstrophy is roughly one tenth the incidence of classic bladder exstrophy, most of the sample likely comprises patients with classic bladder exstrophy.…”

Bladder exstrophy‐epispadias complex

“…The assumption that CE might be due to premature rupture of the CM during early embryogenesis is also challenged by observations from Langer et al (1992) and Kaya et al (2000), reporting prenatal diagnosis of CE by ultrasonographic findings before rupture of the CM. On the other hand, a completely different mechanism has been postulated for the organogenesis of CBE (Beaudoin et al, 2004). Here, observations of the pelvic development in the rabbit embryo imply that bladder and pelvic bone anomalies are related in temporal‐spatial development in exstrophic malformations.…”

Maternal and fetal risk factors for bladder exstrophy: A nationwide Swedish case-control study

“…There are a few studies on pelvic development that suggest that the development of the urinary tract and the pelvic features are tightly connected: for example, the severity of the visceral features seem to be linked to the severity of the lack of rotation in the pelvic ring. [99][100] In an animal model with chick embryos CE was identified and associated with abnormal aneurysmatic swellings of the dorsal aorta, resulting in distention of the developing pelvis and of the infra-umbilical portion of the developing body wall. Eventually, this part then became so thin that it ruptured.…”