Exstrophy of the bladder is a most distressing affliction. Dribbling urine and the necessary self-imposed sexual isolation make the existence of persons so deformed indeed unfortunate.
To live in this way until middle life is bad enough. Then to have a cancer develop on the exstrophy is an unhappy termination to an already pitiable existence. Such was the fate of my patient.
Neudoefer1 estimates the incidence of exstrophy as one in 50,000 persons. Spooner, combining the statistics of Sichel, Winckel and Henon, found it occurring four times in 116,500 birth records. The ratio is 8 males to 1 female.
Of cancer complicating exstrophy, only twelve cases can be found in the literature. Absence of the unbilicus is even more infrequent. Cullen,2 in his exhaustive volume on the umbilicus, reports only one case. E. H. and A. F. Hutchins 3 report its absence in their patient, but describe a
MURPHY DP. EXSTROPHY WITH CANCER OF BLADDER AND ABSENCE OF UMBILICUS: REPORT OF CASE. JAMA. 1924;82(10):784–785. doi:10.1001/jama.1924.02650360026008
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