Bladder Exstrophy in Girls (Differential Diagnosis)

The newborn girl has an externally recognizable malformation in the pubic region. The anomaly in the lower abdomen shows a defect of the abdominal wall with a prolapsing mucous membrane. The external genitals are abnormal and the ligated umbilical cord is swollen and has a hematoma. Bladder exstrophy occurs in girls somewhat less frequently than in boys. The prolapsing mucosa covers partially the posterior wall of the bladder neck and the urethra. On both sides of the latter structures the lateralized labia majora, labia minora, and bladder-ward the split clitoris and prepuce are visible which are swollen. In front of the anus there is normally-appearing meconium.