Rare case of superior vesical fissure with hypospadias: variants of classic bladder exstrophy

Superior Vesical Fissure as an Incomplete Form of Bladder Exstrophy: A Case Report with Clinico-Pathological Correlation and a Comprehensive Literature Review

“…The variability reported in relation to radiological studies performed is high, in part due to the large time window in which the patients are framed (from 1954 to 2023). Cystoscopy (including ours), 3,4,16 intravenous urography/ urogram, 3,4,7,10 intravenous pyelography/pyelogram, 5,11 Roetgenogram, 7,15 voiding cystourethrography 8,14,15,18, and ultrasonography (including ours) 11,13,16,18 have been reported.…”

“…Since then, isolated cases have been reported in Iran, 8 Turquey, 10 Spain (including ours), 12 and most notably India. 9,11,13,14,18 The series reported by Gupta et al in 2003, 14 with nine cases categorizable as a superior vesical fissure, is noteworthy.…”

“…Ten patients (and our patient) presented pubic symphysis separation (existing an important variability in the reports on the characterization of this finding). 3,5,7,8,12,13,15,16,18 It is striking that in the large series reported by Gupta et al 14 no case of pubic symphysis separation was reported. Other associated malformations were dorsal penile curvature, 3 clitoral involvement, 4,8 low umbilicus implantation (including our case), 8,9,[11][12][13]16,18 umbilical hernia, 5,14 urethral malformations, 8,9,11,14 hypospadias, 18 anorectal malformations, 5,9,14 bone defects, 14 genitourinary duplications, 10,14 vesicoureteral reflux, 8,14,15 vertebral anomalies, 12 cardiac anomalies 12 and esophageal atresia.…”

“…Regarding the sociodemographics of the patients, only one case has been reported in adults, 3 being all the others (including ours) pediatric cases. [4][5][6][7][8][9][10][11][12][13][14][15][16]18 Fourteen of the cases were male [3][4][5]9,11,13,14,16,18 and nine of the cases (including ours) were female. 4,5,7,8,10,12,14,15 One article, which reported three patients, did not specify the sex.…”

“…6 Most patients were diagnosed in the neonatal period. 5,7,[9][10][11][12][13][14][15][16] One patient was diagnosed at 7 years of age, 4 one at 2 years of age 8 and another at 1 year of age, 18 One article, which reported three patients, did not specify the age at diagnosis. 6 Regarding the associated malformations, the vast majority of patients had some additional birth defect.…”