Superior Vesical Fissure in a Neonate: A Case Report and Review of Literature

Background: Bladder exstrophy variants are rare congenital anomalies. We present a case of superior vesical fissure, along with a review of the literature. Clinical Description: A 6-day-old full-term female neonate presented with a reddish mucosal plaque below the umbilicus. The external urethral opening appeared normal. The patient had normal external genitalia with an anteriorly placed anus and pubic diastasis. Management and Outcome: A micturating cystourethrogram showed contrast exiting through the mucosal plaque and pubic diastasis. A magnetic resonance imaging pelvis revealed separation of the rectus muscles in the lower part of the abdominal wall and a communication between the bladder and anterior abdominal wall. The patient was taken up for surgery under general anesthesia. The mucosal plate was separated from the skin, and the bladder wall was closed in two layers. The musculofascial layer was approximated in the midline. On follow-up, the patient was healthy with normal bladder voiding. Conclusion: Superior vesical fissure is an uncommonly seen variant of bladder exstrophy, easily diagnosed by passing a feeding tube through the exposed bladder plate. Early surgery results in optimal results.