Superior Vesical Fissure: An Exstrophy Variant or a Distinct Clinical Entity

Kizilcan, F; Fc, Tanyel; Hiçsönmez, A; Büyükpamukçu, Nebìl

doi:10.1159/000475374

Cited by 10 publications

(10 citation statements)

References 3 publications

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“…Case reports from the 1950s and 1960s, most of them belonging to long series of bladder exstrophy in the United States [4][5][6][7]15 were subsequently published. Since then, isolated cases have been reported in Iran, 8 Turquey, 10 Spain (including ours), 12 and most notably India. 9,11,13,14,18 The series reported by Gupta et al in 2003, 14 with nine cases categorizable as a superior vesical fissure, is noteworthy.…”

Section: Discussionmentioning

confidence: 58%

“…Superior vesical fissure, first described by Kittredge et al in 1954, 3 is a mild variant of this pathology in which genital involvement is scarce or absent. To date, there are only isolated reports of this entity, [4][5][6][7][8][9][10][11][12][13][14][15][16] with significant variability among them in terms of clinical presentation, associated malformations, and diagnostic studies for its characterization.…”

Section: Introductionmentioning

confidence: 99%

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Superior Vesical Fissure as an Incomplete Form of Bladder Exstrophy: A Case Report with Clinico-Pathological Correlation and a Comprehensive Literature Review

Arredondo Montero,

Bronte Anaut,

Molina Caballero

et al. 2023

Int J Surg Pathol

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Multiple variants of classic bladder exstrophy have been described, all of them infrequent. Superior vesical fissure is a mild variant of this pathology in which genital involvement is scarce or absent. To date, there are only isolated reports of this entity. We report a full-term female patient of Arabian descent with a clinical and radiological diagnosis of superior vesical fissure that was surgically corrected in our center with a favorable evolution. Histological study, supported by immunohistochemical techniques, showed squamous and transitional epithelium and discrete chronic inflammation. Our literature review identified 26 reports of superior vesical fissure (including ours), with high heterogeneity in terms of clinical characterization and associated malformations and with only two histological reports. The clinical evolution of the patients reported in the literature was favorable, with lower morbidity and mortality than in classical forms of bladder exstrophy.

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Section: Discussionmentioning

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Superior Vesical Fissure as an Incomplete Form of Bladder Exstrophy: A Case Report with Clinico-Pathological Correlation and a Comprehensive Literature Review

Arredondo Montero,

Bronte Anaut,

Molina Caballero

et al. 2023

Int J Surg Pathol

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“…Simple excision of the bowel tissue, resetting of the umbilicus and repair of the epispadias is required. In superior vesical fissure [7] , the musculoskeletal defects of exstrophy are present but only the upper part of the bladder is affected in the exstrophy lesion, so that there is only a small area of bladder tissue protruding through the abdominal wall just below the low-set umbilicus; the genitalia are only mildly affected or may even be normal. In duplicate exstrophy [8] , there is a superior vesical fissure with a normal abdominal wall and the genitalia are again only mildly affected or even normal.…”

Section: Discussionmentioning

confidence: 99%

An Unusual Bladder/Cloacal Exstrophy with Urachal Exstrophy

Sakellaris

Cervellione²,

Dickson³

2008

Urol Int

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The authors report a previously unpublished association of bladder exstrophy with cleft lip, exomphalos, Meckel’s diverticulum imperforate anus, and a large urachal mass protruding below the umbilicus. The baby underwent surgical repair of the condition and the postoperative recovery was uneventful. None of the theories formulated to explain the embryogenesis of bladder exstrophy can explain these findings. The abnormality is within the bladder exstrophy/cloacal exstrophy spectrum.

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“…The chance of this happening to the next child is 1 in 100 or 1 in 70 if the parents have the same history. Risk factors and etiology are unclear and are not historical [ 11 ].…”

Section: Reviewmentioning

confidence: 99%

Analyzing the factors that contribute to the development of embryological classical type of bladder exstrophy

Margiana,

Juwita,

Ima

et al. 2023

Anat Cell Biol

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Bladder exstrophy is a rare congenital condition of the pelvis, bladder, and lower abdomen that opens the bladder against the abdominal wall, produces aberrant growth, short penis, upward curvature during erection, wide penis, and undescended testes. Exstrophy affects 1/30,000 newborns. The bladder opens against the abdominal wall in bladder exstrophy, a rare genitourinary condition. This study is vital to provide appropriate therapy choices as a basis to improve patient outcomes. This study may explain bladder exstrophy and provide treatment. Epispadias, secretory placenta, cloacal exstrophy, and other embryonic abnormalities comprise the exstrophy-spades complex. The mesenchymal layer does not migrate from the ectoderm and endoderm layers in the first trimester, affecting the cloacal membrane. Embryological problems define the exstrophy-aspidistra complex, which resembles epimedium, classic bladder, cloacal exstrophy, and other diseases. Urogenital ventral body wall anomalies expose the bladder mucosa, causing bladder exstrophy. Genetic mutations in the Hedgehog cascade pathway, Wnt signal, FGF, BMP4, Alx4, Gli3, and ISL1 cause ventral body wall closure and urinary bladder failure. External factors such as high maternal age, smoking moms, and high maternal body mass index have also been associated to bladder exstrophy. Valproic acid increases bladder exstrophy risk; chemicals and pollutants during pregnancy may increase bladder exstrophy risk. Bladder exstrophy has no identified cause despite these risk factors. Exstrophy reconstruction seals the bladder, improves bowel function, reconstructs the vaginal region, and restores urination.

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Superior Vesical Fissure: An Exstrophy Variant or a Distinct Clinical Entity

Cited by 10 publications

References 3 publications

Superior Vesical Fissure as an Incomplete Form of Bladder Exstrophy: A Case Report with Clinico-Pathological Correlation and a Comprehensive Literature Review

Superior Vesical Fissure as an Incomplete Form of Bladder Exstrophy: A Case Report with Clinico-Pathological Correlation and a Comprehensive Literature Review

An Unusual Bladder/Cloacal Exstrophy with Urachal Exstrophy

Analyzing the factors that contribute to the development of embryological classical type of bladder exstrophy

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