Immediately after birth of a boy, a moist, red protrusion of tissue is noted just superior to his pubic symphysis. After observation, urine drainage is noted from the upper lateral corners of this tissue mass. What is the diagnosis?

E. The moist, red tissue mass that is exposed to the exterior is actually the posterior wall of the urinary bladder. This is called exstrophy of the bladder and is caused when the anterior abdominal wall and anterior wall of the bladder fail to form. The ureters open onto the posterior wall; therefore, urine drainage is apparent.