title: Shortened pubic bones in bladder exstrophy: a congenital or acquired phenomenon?
abstract: OBJECTIVE
  It is accepted that the length of the anterior segment of the pelvis in classic bladder exstrophy is shorter than that of controls. However, studies performed involve children with a wide range of ages. By studying children with classic bladder exstrophy under the age of 1 year, the authors aim to ascertain if there is a congenital pubic bone length discrepancy associated with bladder exstrophy.
  
  
  METHODS
  Fourteen classic bladder exstrophy patients under 1 year of age and 14 age-matched controls were identified. Three-dimensional (3D) computerized tomography was used to measure the length of the superior pubic ramus bilaterally. In the exstrophy group, scans were performed before bladder closure. The Mann-Whitney U test was used and p < 0.05 was considered significant.
  
  
  RESULTS
  There was no significant difference (p = 0.76) in the median age in cases (72 days) and controls (64 days). The median superior pubic ramus length was 19.1 mm in the exstrophy group and 20 mm in the control group (p = 0.99).
  
  
  CONCLUSIONS
  Superior pubic ramus length in children under 1 year of age with classic bladder exstrophy is not statistically different from that in control subjects. Therefore, the authors hypothesize that the previously described shortening of the pubic bones is an acquired phenomenon, which may develop after the first year of life.
authors.affiliation: Department of Paediatric Urology, Royal Manchester Children's Hospital, Oxford Road, Manchester M13 9WL, UK.
authors.forename: Linda
authors.initials: L
authors.lastname: Stephens
authors.affiliation: Department of Paediatric Urology, Royal Manchester Children's Hospital, Oxford Road, Manchester M13 9WL, UK.
authors.forename: Alberto
authors.initials: A
authors.lastname: Mantovani
authors.affiliation: Department of Paediatric Urology, Royal Manchester Children's Hospital, Oxford Road, Manchester M13 9WL, UK.
authors.forename: David J B
authors.initials: DJ
authors.lastname: Keene
authors.affiliation: Department of Paediatric Urology, Royal Manchester Children's Hospital, Oxford Road, Manchester M13 9WL, UK.
authors.forename: Alan P
authors.initials: AP
authors.lastname: Dickson
authors.affiliation: Department of Paediatric Orthopaedic Surgery, Royal Manchester Children's Hospital, Manchester, UK.
authors.forename: Tahir
authors.initials: T
authors.lastname: Khan
authors.affiliation: Department of Paediatric Radiology, Royal Manchester Children's Hospital, Manchester, UK.
authors.forename: Abdusamea
authors.initials: A
authors.lastname: Shabani
authors.affiliation: Department of Paediatric Urology, Royal Manchester Children's Hospital, Oxford Road, Manchester M13 9WL, UK. Electronic address: Raimondo.Cervellione@cmft.nhs.uk.
authors.forename: Raimondo M
authors.initials: RM
authors.lastname: Cervellione
mesh_terms: D000367:Age Factors; D001746:Bladder Exstrophy / Q000000981:diagnostic imaging* / Q000601:surgery; D016022:Case-Control Studies; D000013:Congenital Abnormalities / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011630:Pubic Bone / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D012016:Reference Values; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D006113:United Kingdom
keywords: Bladder exstrophy; Bone growth; Bony pelvis; Computerized tomography scan; Pubic bones