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Topic: Cloacal exstrophy

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	Association for Bladder Exstrophy Community - Glossary
		In females with cloacal exstrophy, the clitoris is divided in two halves, again at the base of the bladder, and the pubic bones are widely split.
		A dehiscence in the exstrophy population typically means that the pubic bones and abdominal wall closure have split apart and the bladder is reexstruded onto the abdomen wall.
		In the bladder exstrophy population, osteotomies are used to help reconstruct the pelvic bones and the pelvic floor which removes tension from the abdominal wall and bladder closure thereby aiding in the success of the exstrophy reconstruction.
	www.bladderexstrophy.com /glossary.htm (2894 words)

	Anterior Abdominal Wall - DIAGNOSIS OF CONGENITAL ABNORMALITIES - THE 18-23 WEEKS SCAN
		Bladder exstrophy is a defect of the caudal fold of the anterior abdominal wall; a small defect may cause epispadias alone, whilst a large defect leads to exposure of the posterior bladder wall.
		Cloacal exstrophy (also referred to as OEIS complex) is the association of an omphalocele, exstrophy of the bladder, imperforated anus, and spinal defects such as meningomyelocele.
		Bladder exstrophy should be suspected when, in the presence of normal amniotic fluid, the fetal bladder is not visualized (the filling cycle of the bladder is normally in the range of 15 min); an echogenic mass is seen protruding from the lower abdominal wall, in close association with the umbilical arteries.
	www.centrus.com.br /DiplomaFMF/SeriesFMF/18-23-weeks/chapter-06/abdome_fmf.html (1118 words)

	TheFetus.net - Exstrophy of the cloaca sequence -Roy Erb, MD, Richard Jaffe, MD, Victor Braren, MD, Philippe Jeanty, ...
		Cloacal exstrophy is a rare congenital anomaly that is the most severe form of the exstrophy—epispadias complex.
		The association of an omphalocele, exstrophy of the cloaca, imperforated anus and spinal abnormalities (meningocele) is referred to as the OEIS complex.
		Marshall VF and Muecke EC: Variationbs in exstrophy of the bladder.
	www.thefetus.net /page.php?id=569 (2448 words)

	Association for Bladder Exstrophy Community - Frequently Asked Questions
		The word Exstrophy is derived from the Greek word ekstriphein, which literally means to "turn inside out." Bladder exstrophy is a malformation of the bladder, in which the bladder and related structures are turned inside out.
		However, children with exstrophy should be able to run, jump, and play normally despite the pelvic deformity, and there is no evidence that exstrophy results in arthritis of the hips in later years.
		Cloacal exstrophy: The incidence of cloacal exstrophy is 1:200,000 and is much less common in females.
	www.bladderexstrophy.com /faq.htm (1434 words)

	Cloacal exstrophy - Children's Hospital Boston
		Cloacal exstrophy is a rare and complicated defect that occurs during the prenatal development of the lower abdominal wall structures.
		Many times children born with cloacal exstrophy are also born with varying degrees of spina bifida.
		Cloacal exstrophy can usually be diagnosed by fetal ultrasound before an infant is born.
	www.childrenshospital.org /az/Site2187/printerfriendlypageS2187P0.html (980 words)

	The 18-23-week scan - Chapter 6.05
		Bladder exstrophy is found in 1 per 30,000 births and cloacal exstrophy is found in about 1 in per 200,000 births.
		Bladder exstrophy should be suspected when, in the presence of normal amniotic fluid, the fetal bladder is not visualized (the filling cycle of the bladder is normally in the range of 15 min); an echogenic mass is seen protruding from the lower abdominal wall, in close association with the umbilical arteries (see
		In cloacal exstrophy, the findings are similar to bladder exstrophy (large infraumbilical defect that extends to the pelvis), but a posterior anomalous component (meningomyelocele) is present.
	www.fetalmedicine.com /18-23scanbook/Chapter6/chap06-05.htm (279 words)

	eMedicine - Exstrophy and Epispadias : Article Excerpt by: Elizabeth B Yerkes, MD (Site not responding. Last check: 2007-11-01)
		Cloacal exstrophy is a much more severe abnormality, with significant involvement of the GI tract and CNS.
		In the US: Prevalence of classic bladder exstrophy is 3.3 per 100,000 births; male epispadias occurs in 1 in 117,000 births, female epispadias in 1 in 484,000 births, and cloacal exstrophy in 1 in 200,000-400,000 births.
		Cloacal exstrophy was associated historically with significant mortality.
	www.emedicine.com /ped/byname/exstrophy-and-epispadias.htm (389 words)

	Hypospadias, exstrophy, epispadias, ambiguous genitalia, double vagina and other abnormalities of the female external ...
		Cloacal exstrophy presents with an impressive anatomic array of associated external defects, including the exstrophic cecum and terminal ileal segment separating the bladder into two exstrophic halves.
		Although bladder exstrophy is not usually a life-threatening entity, severe cloacal exstrophy may be.
		Cloacal exstrophy is a greater challenge than classic bladder exstrophy.
	www.ccspublishing.com /journals4a/abn_genit_female.htm (2001 words)

	Cloacal Exstrophy (Site not responding. Last check: 2007-11-01)
		Cloacal exstrophy is often referred to by different labels including: Vessico Intestinal Fissure, Exstrophy of the Cloaca, Exstrophia of the Spalancia, and OEIS Complex.
		O-Omphalocele-This is a defect of the abdominal wall, which means that the child was born with the abdominal viscera outside of the abdominal cavity, covered by a thin membrane.
		Most children with cloacal exstrophy are very intelligent and there is no evidence that suggests that they have a lower IQ than the rest of the population.
	www.pullthrough.org /ptnn12.html (1090 words)

	Intersex Community Forums \| Bodies Like Ours - "Intersex-ual" ?
		Cloacal exstrophy is not an intersex condition: aphallia and phallic inadequacy are structural anomalies.
		Cloacal exstrophy: A complex anomaly of the abdominal wall, the intestinal tract and the pelvic organs.
		Infants with cloacal exstrophy have a short intestine, an absent anus, a large defect of the abdominal wall (omphalocele) and the bladder (which is exposed and lacks a front wall), and anomalies of the pelvic bone and genitalia.
	www.bodieslikeours.org /forums/printthread.php?t=836&page=8&pp=9 (5253 words)

	Swiss Society of Neonatology
		Exstrophy of the cloaca sequence occurs approximately 1 in 200’000 to 400’000 births (1).
		In genotypic males with exstrophy of cloaca sequence, the phallic size is usually small and reconstruction of an adequate penis is nearly impossible.
		Surgical management of babies born with cloacal extrophy sequence has progressed over the years and reasonably good outcome is being reported in the literature.
	www.neonet.ch /en/03_Case_of_the_month/archive/09_renal_and_genitourinary_systems/2006_02.asp?navid=19 (679 words)

	1118-1124
		The surgical methods commonly employed to repair the abdominal wall defect present in cloacal exstrophy, omphalocele, and gastroschisis during the neonatal period include (1) definitive primary muscle, fascia and skin closure, (2) primary skin closure only with late ventral hernia repair, and (3) a staged closure employing a silo.
		A porcine SIS graft was used for closure in 1 patient with a giant omphalocele associated with cloacal exstrophy and in 1 patient with gastroschisis.
		We conclude these grafts may be used successfully in infants with a giant omphalocele associated with cloacal exstrophy, and in infants with complicated omphalocele or gastroschisis.
	www.plasticsurgery.org /PSF/PSFHOME/educate/abstracts/Sunday/B/1118-1124.htm (881 words)

	eMedicine - Exstrophy and Epispadias : Article by Elizabeth B Yerkes, MD
		Cloacal exstrophy: The penis is generally quite small and bifid, with a hemiglans located just caudal to each hemibladder.
		Exstrophy variants: In these split-symphysis variants of exstrophy, the pubic symphysis is widely separated, and the rectus muscles are divergent.
		Congenital upper urinary tract anomalies are uncommon with classic exstrophy and epispadias but are present in approximately one third of patients with cloacal exstrophy (eg, ectopic pelvic kidney, renal agenesis, hydronephrosis).
	www.emedicine.com /ped/topic704.htm (5590 words)

	Cloacal exstrophy -
		Cloacal exstrophy is a severe birth defect wherein much of the abdominal organs (the bladder and cloacal exstrophy intestines) are exposed.
		It often causes the splitting of both male and female genitalia cloacal exstrophy dominican republic (specifically, the penis and clitoris respectively), and the anus is occasionally sealed.
		A disease is any abnormal condition of the body or mind that causes discomfort, dysfunction, or distress to the person affected or those in contact with the person.
	www.medicalgeo.com /Med-Diseases-Ci---Cy/Cloacal-exstrophy.html (158 words)

	Bladder exstrophy - Wikipedia, the free encyclopedia
		Treatment is with surgical correction of the defect, but patients can still have long term issues with urinary tract infections and sexual dysfunction.
		The cause of bladder exstrophy is maldevelopment of the lower abdominal wall, leading to a rupture which causes the bladder to communicate with the amniotic fluid.
		The spectrum of disease extends from spade penis and epispadias on one hand, to exstrophy with cloaca (also known as cloacal exstrophy).
	en.wikipedia.org /wiki/Bladder_exstrophy (218 words)

	Cloacal exstrophy sequence: an exceptional ultrasound diagnosis -- Meizner et al. 86 (3): 446 -- Obstetrics & Gynecology
		The sonographic findings in each case of cloacal exstrophy sequence were evaluated and compared with the ultrasonic manifestations in other types of anterior abdominal wall defects.
		RESULTS: During the study period, six cases of cloacal exstrophy were diagnosed by ultrasound and confirmed by postnatal autopsy examination.
		These signs distinguish cloacal exstrophy from other types of midline anterior abdominal wall defects, ie, gastroschisis, amniotic band syndrome, and limb-body wall complex (body-stalk syndrome).
	www.greenjournal.org /cgi/content/abstract/86/3/446 (329 words)

	Epispadias - Wikipedia, the free encyclopedia
		An epispadias is an uncommon and partial form of a spectrum of failures of abdominal and pelvic fusion in the first months of embryogenesis.
		Most cases involve more severe defects, including a small and bifid phallus with bladder exstrophy or even cloacal exstrophy involving the entire perineum.
		Despite the similarity of name, an epispadias is not a type of hypospadias, and involves a problem with a different set of embryologic processes.
	en.wikipedia.org /wiki/Epispadias (146 words)

	Bladder Exstrophy-Epispadias-Cloacal Exstrophy Complex
		Bladder exstrophy-epispadias-cloacal exstrophy complex is a spectrum of anomalies involving the urinary tract, genital tract, musculoskeletal system and sometimes the intestinal tract.
		Bladder exstrophy is a rare developmental abnormality that is present at birth (congenital) in which the bladder and related structures are turned inside out.
		The extent of the exstrophy depends on how large the opening is. The mildest form is when there is a defect or opening in the tube that carries urine out of the body from the bladder (urethra) and is termed epispadias.
	www.meritcare.com /hwdb/showtopic.aspx?pd_hwid=nord195 (522 words)

	Abnormalities of the Female External Genitalia - New Treatments, May 2, 2006
		Classic bladder exstrophy is found in approximately 1 in 30,000 births and accounts for 60% of the various anomalies seen.
		The most commonly espoused theory for exstrophy development comes from the work of Marshall and Muecke, who postulated that early in gestation the cloacal membrane develops abnormally.
		The typical migration of mesenchyme from the lateral margins of the cloacal membrane medially is inhibited
	www.ccspublishing.com /journals2a/abn_genit_female.htm (1094 words)

	Epispadias
		Bladder Exstrophy is a congenital birth defect that is the malformation of the bladder and urethra, in which the bladder is turned "inside out"...
		Cloacal exstrophy is commonly associated with other anomalies...
		70 - 90 % of patients with cloacal exstrophy have an omphalocele...
	ibis-birthdefects.org /start/epispadi.htm (675 words)

	BLADDER EXSTROPHY : Contact a Family - for families with disabled children: information on rare syndromes and disorders
		The exstrophy epispadias complex is a spectrum of disorders ranging in severity from epispadias through bladder exstrophy to cloacal exstrophy.
		The characteristic features of bladder exstrophy are: a bladder that opens directly onto the abdominal wall; abnormal genitalia; and where the bony part of the pelvis has remained open.
		Cloacal exstrophy is the most severe end of the epispadias-exstrophy complex, consequently the chance of normal voiding is extremely small.
	www.cafamily.org.uk /Direct/b21.html (861 words)

	[No title] (Site not responding. Last check: 2007-11-01)
		Cloacal exstrophy due to failrue of hind gut development.
		Cloacal exstrophy, bladder is dissected free from the anterior abdominal wall before bladder turn-in and abdominal wall closure
		Reconstruction of cloacal exstrophy composes of : 1.
	cai.md.chula.ac.th /lesson/atlas/N/page2n.html (154 words)

	Cloacal Exstrophy - Talk Medical
		Cloacal exstrophy: A birth defect involving the pelvic area that is termed a malformation sequence and involves the cloaca.
		In exstrophy of the cloaca, an area of the intestine is interposed between two separate areas of the bladder.
		Boys with cloacal exstrophy have cryptorchidism (failure of descent of the testes into the scrotum) and very severe epispadias (with the urine opening above the phallus).
	www.talkmedical.com /medical-dictionary/3071/Cloacal-Exstrophy (232 words)

	TheFetus.net - Case of the week # 12 -Alberto Sosa Olavarria, MD & Luis Guillermo Diaz Guerrero, MD, Valencia, Venezuela
		rupture of the cloacal membrane with cloacal exstrophy,
		4- Austin PF.The prenatal diagnosis of cloacal exstrophy.
		Prenatal diagnosis of fetal bladder and cloacal exstrophy by ultrasound.
	www.thefetus.net /link.php?id=1141 (1089 words)

	Intersex Initiative: News - Study Questions Sex Change for Children with Cloacal Exstrophy
		"Cloacal exstrophy" is a rare medical condition in which the development of lower abdominal wall structures is incomplete, causing a portion of the child's intestines to be exposed outside of the body.
		It can occur in both genetic males as well as females, but gender assignment becomes a concern in the case of genetic males with cloacal exstrophy, where the penis is short, absent, or split in half.
		In the paper published in the January 22, 2004 issue of The New England Journal of Medicine Reiner and Gearhart studied sixteen genetic males who had gone through Johns Hopkins' cloacal exstrophy clinic in the past, fourteen of whom have been assigned female; the remaining two were assigned male.
	www.intersexinitiative.org /news/000103.html (538 words)

	Cloacal Exstrophy (Site not responding. Last check: 2007-11-01)
		The cloacal membrane normally ruptures leaving only the urogenital sinus (the urethra and vaginal introitus) and the rectum patent.
		If rupture of the cloacal membrane occurs before the uro-rectal septum has separated the bladder from the hind gut, the urethra, bladder and large bowel lie open as plates of mucosa on the lower abdomen.
		Notice that the bladder is actually two patches of mucosa, each with its own ureteric orifice, lying on either side of a patch of large bowel.
	www.meddean.luc.edu /lumen/MedEd/urology/cloaexst.htm (105 words)

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