Cloacal exstrophy: a 22-year experience.

Our 22-year experience in the management of 12 patients with cloacal exstrophy is discussed. All patients underwent functional bladder closure. Of 7 evaluable patients 3 (43 per cent) have continent intervals of 3 to 4 hours and constitute the first report of satisfactory urinary continence following functional bladder closure in patients with cloacal exstrophy. Of 8 patients with an XY karyotype 6 were raised as girls with satisfactory genitoplasty, while 2 raised as boys had functionally inadequate external genitalia. The management of the rudimentary hindgut varied and the alternative approaches are discussed. It appears that this patient population can be rehabilitated to lead productive lives.