Two cases of exstrophy of the cloaca with myelocystocele are presented. Medical-surgical evaluation of the patient plus social-psychological assessment of the family determined an early decision to initiate therapy in one case in contrast to delayed evaluation and an unsuccessful attempt to treat in the other.
Short gut, inadequate urinary drainage, paraplegia and absent genitalia may complicate treatment. However, barring extensive upper intestinal malformation, exstrophy of the cloaca is not a lethal defect; therefore, the decision to not undertake surgical closure requires continued medical care for the infant and continued social and economic support for the family.
Hayden PW, Chapman WH, Stevenson JK. Exstrophy of the Cloaca. Am J Dis Child. 1973;125(6):879-883. doi:10.1001/archpedi.1973.04160060077018