PMC5869060_01
Post-corporeal caesarean section image showing the untreated exstrophic bladder. Operative incision was well healed. Bladder exstrophy was untreated. Umbilicus was absent and inner surface of the posterior wall of the bladder occupied the lower central abdomen. The mucosal edges of the exstrophic bladder were fused with the skin. J-tubes were inserted in both ureteral orifices and connected with urine collecting bags. Vaginal orifice located below exstrophic bladder as line shape and meatus urinarius was absent.
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A transverse incision 12 cm long was made in the skin located three-horizontal-finger distance above the upper edge of exstrophic bladder (Fig. 1).
Bone radiography of pelvis. X-ray revealed the rami of the pubic bones were chondrified and separate by 14 cm. Circuitous inserted J-tube image is shown on the left of the image.
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We believe the J-tube followed this circuitous trajectory as a result of ureterovesical obstruction, which led to pyeloureterectasis and circuitous ureter (Fig. 2).