Understanding Cloacal Exstrophy

Cloacal exstrophy is a rare birth defect that affects the development of the lower abdominal wall. Babies with cloacal exstrophy are born with their pelvic organs (bladder, genitals, and large intestine) outside of their body. This condition affects the urinary, digestive, and reproductive systems.

Cloacal exstrophy occurs during fetal development and is diagnosed during pregnancy through ultrasound. Once your child is born, it is confirmed by a physical examination.

A diagnosis can be overwhelming for parents. There are resources and support to help provide comfort and connection to other families who are facing similar challenges. Please speak to your physician if you have any questions.

Signs and Symptoms

  • Exposed bladder, appearing as a red, raw area on the lower abdomen
  • Part of the intestines may protrude through an opening
  • In males, the penis may be flat, short, or divided into two halves
  • In females, the clitoris, uterus, and vagina may be separated into two parts
  • Other conditions may be present, such as spina bifida, heart defects, or imperforate anus

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Pediatric Surgery

Treatment

Cloacal exstrophy requires surgical repair. Depending on the severity of this complex condition, a multidisciplinary team of pediatric colorectal surgeons, urologists, gynecologists, gastroenterologists, orthopedists, and other specialists is usually involved throughout the treatment process, starting from birth.

Multiple surgeries are typically completed in stages throughout childhood and may include procedures to repair the bladder, intestinal area, and genitalia. Additional surgeries may be needed for any associated conditions of the spine or pelvis.

After surgery, children who have cloacal exstrophy may still have bladder or bowel control problems. However, with follow-up visits, our health care team can help manage your child’s bowel and bladder control and improve a child’s overall quality of life.

For treatment of cloacal conditions, explore our Comprehensive Congenital Colorectal Program.

Please visit our pediatric surgery page to schedule a visit or learn more about our physicians and services.