Evolution of Cloacal Exstrophy Research: A Comprehensive Bibliometric and Scientometric Assessment.

BACKGROUND

Cloacal exstrophy (CE) is among the most complex congenital anomalies, involving multiple organ systems and requiring multidisciplinary care. While surgical and clinical advances have been significant, no comprehensive analysis of research trends, collaboration, and thematic evolution exists. Bibliometric analysis can map the scientific landscape, highlighting key contributors, gaps, and emerging directions.

OBJECTIVE

The objective of this study was to conduct a bibliometric and scientometric assessment of cloacal exstrophy research, evaluating publication trends, authorship, institutional productivity, collaborations, and thematic evolution from 1959 to 2025.

MATERIALS AND

METHODS

A systematic bibliometric analysis of the Scopus database (August 2025) was performed. Data were analyzed using Scopus tools, VOSviewer (v1.6.20) for visualization, and Bibliometrix (v4.1.2) for indicators. Metrics included publication output, co-authorship networks, institutional and international collaborations, keyword co-occurrence, and citation analysis.

RESULTS

A total of 289 publications were identified between 1959 and 2025, with a peak in 2011 (15). Original articles comprised 75%. The USA led output (162, 56%), with Johns Hopkins institutions contributing most (176). Gearhart was the most prolific author (46, h-index 14). The Journal of Urology and Journal of Pediatric Surgery were the main publication outlets. Thematic evolution progressed from descriptive studies to surgical outcomes, prenatal diagnosis, and refinements. The most cited work addressed gender identity considerations.

CONCLUSIONS

CE research is concentrated in specialized US centers, showing thematic shifts aligned with advances in fetal medicine and surgery. The observed bibliometric patterns suggest a relatively established research structure within the field. Future efforts should strengthen international collaboration and address adult outcomes and novel therapeutic strategies.