A prenatal sonogram suggestive of exstrophy will usually indicate a low disposition umbilicus along with the absence of bladder filling. An intravenous pyelogram is often performed to determine the extent of the anomaly and to diagnosis other associated or related anomalies. Surgical intervention is necessary to correct this condition. Formerly, surgical repair of severe cases of exstrophy were in vain. Advances in neonatal care, nutrition, anesthesia, and other surgically-related principles have led to improved results in the management of exstrophy.
Surgical repair involves staged reconstruction.
Closure of the bladder and abdomen usually occurs in the first 24-72 hours of life. Epispadius repair in males occurs at 2 to 3 years of age, and urinary continence along with ureteral reimplantation is done at age 4 to 5. The pubic symphysis is normally less than 1 cm., but those with exstrophic bladders often have a separation of up to 10 cm. Surgery and traction are necessary for correction. Reflux of urine into the ureters becomes serious during infections.