The management of bladder exstrophy (BE) remains one of the most significant challenges encountered by pediatric urologists despite improvements in the operative techniques worldwide. Regardless of surgical technique, timing of primary closure remains a matter of debate. The initial closure may be performed within the first 48-72 hours of life or at ~6-12 weeks of age. Delayed presentation until adolescence is extremely rare. However, due to lack of awareness, and access to healthcare along with poor socioeconomic conditions in developing countries, some patients may not receive treatment during infancy. We present a case of a 10-year-old Syrian male with BE associated with complete rectal prolapse who did not undergo any previous surgical interventions.
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