The genital aspects of exstrophy.

Genital anomalies associated with exstrophic deformities are mainly caused by the wedge effect of the cloacal membrane. The more primitive the exstrophy the more severe are the genital defects. With exstrophy of the cloaca genital tract invariable. The main practical problem relates to the male subject with epispadias alone or in association with bladder exstrophy. Correction of the penile deformity requires release of the chordee by freeing the short urethra from the corpora cavernosa and lengthening the organ by partial separation of the crura from the bony rami. The possession of an adequate phallus is generally the prime consideration of the patient and his parents, and surgical reconstruction should aim to provide maximal correction of the anomalies at an early age.