title: Antenatally diagnosed cloacal exstrophy variant with intravesical phallus in a twin pregnancy.
abstract: We report a rare case of covered cloacal exstrophy variant with a hemiphallus trapped within partially closed bladder halves. The persistence of the cloacal membrane until at least 18 weeks' gestation, confirmed by antenatal ultrasound scanning, is discordant with existing theories of embryogenesis of cloacal exstrophy. The clinical presentation highlights the need for careful assessment, before and during surgery, to obtain a complete understanding of the anatomic defect before gender assignment and appropriate reconstructive efforts. A multispecialty approach and antenatal counseling are important, especially when only one fetus of twins has major birth defects.
authors.affiliation: Department of Surgery, Division of Urology, University of Massachusetts Medical School, Worcester, Massachusetts 01655, USA.
authors.forename: Y
authors.initials: Y
authors.lastname: Lakshmanan
authors.forename: P B
authors.initials: PB
authors.lastname: Bellin
authors.forename: A M
authors.initials: AM
authors.lastname: Gilroy
authors.forename: L C
authors.initials: LC
authors.lastname: Fung
mesh_terms: D000015:Abnormalities, Multiple / Q000000981:diagnostic imaging / Q000601:surgery; D001006:Anus, Imperforate / Q000601:surgery; D001746:Bladder Exstrophy / Q000000981:diagnostic imaging / Q000196:embryology* / Q000601:surgery; D004200:Diseases in Twins / Q000196:embryology; D017809:Fatal Outcome; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010413:Penis / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D014463:Ultrasonography