Bladder exstrophy is a birth defect in which the front wall of the bladder and lower belly did not close, leaving the inside of the bladder exposed on the skin. It is spotted at birth and affects how urine leaves the body.

The main sign is an open bladder plate. A bright red, wet patch of bladder lining sits on the lower belly instead of being inside the pelvis.

Urine leaks constantly. Drops dribble from the exposed plate onto the skin, so the baby’s diaper is wet even before the first normal pee.

The pubic bones are spread apart, so the belly button looks low and the penis or clitoris appears shorter and often split.

The penis may curve downward (epispadias) and the urethra is open on top, making the stream spray upward or split.

Skin around the plate gets irritated quickly. Redness, raw spots, and a urine smell are common because the area is always wet.

Later, if not repaired, constant leakage, repeated infections, and lower belly pain can occur as the child grows.