Question 1

Q: Regarding ectopia vesicae, which of the following is true EXCEPT?

There is a ventral curvature of the penis.. **Explanation** Ectopia vesicae (Bladder Exstrophy) is a complex congenital malformation resulting from a failure of the infra-umbilical anterior abdominal wall and bladder neck to fuse. **Why Option B is the correct answer (The Exception):** In ectopia vesicae, the penis is typically short and broad with a **dorsal curvature** (chordee), not a ventral one. This is because the urethral groove is open on the dorsal surface (Epispadias), and the corpora cavernosa are separated and shortened, pulling the penis upward toward the abdominal wall. Ventral curvature is characteristic of Hypospadias, not Exstrophy-Epispadias complex. **Analysis of other options:** * **Option A (True):** Chronic irritation and metaplasia of the exposed bladder mucosa significantly increase the risk of malignancy, most commonly **Adenocarcinoma** (due to glandular metaplasia), unlike the usual transitional cell carcinoma. * **Option C (True):** Since the bladder neck and sphincteric mechanisms are malformed and open, there is no reservoir function, leading to continuous **total incontinence**. * **Option D (True):** Because the posterior bladder wall (trigone) is exposed to the exterior, the ureteric orifices are visible, and one can directly observe the intermittent **efflux of urine** from them. **High-Yield Clinical Pearls for NEET-PG:** * **Associated skeletal finding:** Widening of the symphysis pubis (diastasis). * **Umbilicus:** Positioned lower than normal. * **Management:** Primary closure is ideally performed within 48–72 hours of birth. * **Most common malignancy:** Adenocarcinoma of the bladder. * **Key distinction:** Epispadias is always present in bladder exstrophy.

Question

Regarding ectopia vesicae, which of the following is true EXCEPT?

Accepted Answer

There is a ventral curvature of the penis.

Answer

Carcinoma of the bladder may occur.

Answer

There is incontinence of urine.

Answer

There is visible uretero-vesical efflux.

Pediatric Surgery — MCQs

Pediatric Surgery — MCQs

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