What is Cloacal Exstrophy?

Cloacal exstrophy affects the formation of the lower abdominal wall of the developing fetus. It means that since the wall does not properly form, bladder and a part of the large intestine (colon) are engulfed in a membrane on the exterior of the body at birth. The disease also affects a child's genitals.

This is a type of birth defect or congenital urinary anomaly. That is, it occurs during a baby's development in the womb; therefore, at birth this condition is usually present. Most children who have it do well after a set of corrective surgeries that come shortly after birth.

What is the effect of cloacal exstrophy on the genitals of a child?

Cloacal exstrophy also involves a child's genitals.

The penis of the male reproductive system could be flat, short or divided into a right and left half.
The clitoris of the female reproductive system is divided into a right and left half. The vaginal openings are two in number.

What are the symptoms of cloacal exstrophy?

Cloacal exstrophy signs and symptoms are evident at birth. Your baby may have:

Organs within a pouch that protrudes through an opening in his belly.
Divided penis or vagina.
A sac bulges through an opening in the back (spina bifida).

What causes cloacal exstrophy?

Doctors do not know what can cause this congenital disability. During the first three months of pregnancy, a layer of tissue called the cloacal membrane splits open.

This is the site where the reproductive, digestive, and urinary systems meet. A membrane known as the cloacal membrane usually separates the organs involved in these systems. Upon this tear, the abdominal wall fails to develop normally. Organs either need to be established appropriately or sometimes merge in a faulty arrangement. Some organs bulge out from an opening in the abdominal region.

How is cloacal exstrophy diagnosed?

A prenatal ultrasound often diagnoses cloacal exstrophy during a pregnancy. Additionally, you may be taken through fetal MRI, in which there will be detailed images of the organs of the fetus. Such examination can reveal the following effects:

The bladder isn't emptying.
Separated pubic bones (the bones that make up the pelvis).
Small genitalia.
The umbilical cord attaches too low on the fetus's belly due to the omphalocele.

After birth, an MRI, abdominal ultrasound, or other tests may be conducted to assess how organs function and the disease's severity. It helps your doctor determine the most appropriate treatment plan for your child.

How is cloacal exstrophy treated or managed?

All the babies born with cloacal exstrophy will be in a position to require multiple surgical operations for organs to be implanted in appropriate sites and for abdominal and spinal openings to close.

Your child will experience a number of operations carried out for many years, called staged reconstruction.

The treatment given near birth time involves:

Reconstruction of the bladder to position the organs within the abdominal cavity to close the abdominal opening.
Creating an opening in the abdomen that allows stool from the large intestine to pass into a pouch outside the body. A colostomy pouch may be a temporary measure until other surgeries can be done.
Closing the hole in the spinal cord.

Treatments during early childhood may include:

Formation of anus. When there is adequate amount of large intestine, then pull through surgery can be carried out for attaching the large intestine with the rectum and thereafter the surgeon closes the stoma.
Re-construction of the reproductive organs and urinary tract.
Pelvic bone cutting also known as osteotomy. This enables the pelvis to close more easily and helps support the bladder since your child grows.

What are the risks and complications associated with cloacal exstrophy?

In most patients, children with cloacal exstrophy survive all surgical treatments and lead active, full lives. Many require more surgeries as they mature.

Cloacal exstrophy is associated with an increased risk for:

Infertility
Kidney disease and kidney infections; kidney stones and kidney failure
Erectile dysfunction and other sexual dysfunction
Urinary incontinence; fecal (bowel) incontinence

What questions should I ask my provider?

You might ask your child's doctor:

Does my child have a higher risk for other medical conditions?
What is the best therapy for cloacal exstrophy?
How many surgeries will my child require?
What complications should I look out for after the surgery?
What is my chance of having another child afflicted with cloacal exstrophy?

Why Choose Tender Palm Super Speciality Hospital for cloacal exstrophy treatment in Lucknow, India?

Tender Palm Super-Speciality Hospital has the most trusted team of Pediatric Urologists with advanced diagnostic equipment and child-friendly care for Cloacal Exstrophy treatment in Lucknow, India. Our Pediatric Urology department follows international safety standards and has years of experience in successfully managing children's Urological diseases.