Assessment of the anterior osteotomy role in restoration of normal pelvic floor anatomy for bladder exstrophy patients using pre-operative and post-operative pelvic floor MRI / Mohamed Alaa Eldin Elzoheiry ; Supervised Mohamed Amr Lotfi , Hany Elfayoumy , Ahmed Ismail Shoukry

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Urology

The most popular embryological theory explaining the exstrophy-epispadias defect describes an overgrowth of the cloacal membrane that prevents medial migration of the mesenchymal tissue. This prevents the fusion of midline structures below the umbilicus. (Muecke EC, 1964) Bladder exstrophy is a part of a spectrum of anomalies involving the urinary tract, genital tract, musculoskeletal system, and sometimes the intestinal tract. In classic bladder exstrophy (CBE), most anomalies are related to defects of the abdominal wall, bladder, genitalia, pelvic bones, rectum, and anus. (Sarel H. et al., 2003) Children with bladder exstrophy have an everted bladder, epispadias, wide diastasis of the pubic symphysis, and pelvic muscular defects. In boys, the penis is short with wide separation of the corporal attachments. There is a cephalad (dorsal) curvature of the penis. In girls the clitoris is bifid

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