Bladder exstrophy and epispadias is a congenital condition, meaning that individuals are born with it. In bladder exstrophy, the skin over the lower abdomen (belly) does not form properly, leaving the bladder, an internal organ that holds urine, exposed. In epispadias, the urethra, the tube that guides urine out of the body, does not form properly. In boys, the urethra may be very short and split. This can cause the urethra to come out at the top of the penis rather than at the end. The full length of the penis may be affected, making it very short and wide. In girls, the opening of the urethra is higher and wider than usual. The labia (folds of the vagina) are farther apart and and the clitoris (small sensitive part of the vagina) is split in two.The middle part of the pelvic bone (hip bone) of babies born with this condition may also be separated. Affected babies have trouble urinating and must undergo surgery. About one in 40,000 babies are born with this condition.