Surgical embryology of the exstrophy-epispadias complex.

Among the developmental anomalies seen in children, few has as broad a spectrum as the exstrophy-epispadias complex which encompasses numerous abnormalities arising in the hind-end of the embryo. Table 1, the scheme proposed by Marshal and Muecke, depicts the developmental relationships of the variations within the complex. One can readily appreciate the multifaceted nature of a syndrome which can produce deformities as mild as spade penis or patulous rectum on the one hand, while involving severe, complex derangements of the urinary, genital, alimentary, and musculoskeletal systems on the other hand.