The exstrophy-epispadias complex in the duplicated lower urinary tract.

PURPOSE

The exstrophy-epispadias complex in combination with a duplicated lower urinary tract is an extremely rare congenital malformation. We describe 2 cases of bladder exstrophy in association with a duplicated lower urinary tract.

MATERIALS AND METHODS

We analyzed the case histories of 2 patients. The first case had anteroposterior duplication of the bladder communicating through an isthmus and a duplicate urethra. The anterior system was exstrophic and epispadiac. The second case had a duplicate bladder without epispadias. There was a communication between the anterior exstrophic and posterior normal bladders. No other malformations were present.

RESULTS

Both patients underwent excision of the duplicate exstrophic bladder in conjunction with primary closure of the abdominal wall. Postoperative continence was normal. Histological examination confirmed the diagnosed bladder duplication.

CONCLUSIONS

Although duplication of the lower urinary tract in combination with the exstrophy-epispadias complex is extremely rare, all children presenting with an exstrophic bladder and a normal urethra alone or in association with an epispadiac anterior urethra should be evaluated for a bladder duplication with possible isthmic communication.