People with bladder exstrophy are born with their urinary bladder exposed (through an open abdominal wall) or outside of the body. They may also have an open pelvis (resulting from the pubic bones not joining together), which causes genital differences. People with bladder exstrophy and XY chromosomes often have a shorter-than-typical penis with epispadias (meaning the urethra opens on the top surface of the penis instead of at the tip) and undescended testes. People with XX chromosomes and bladder exstrophy often have a urethra that is placed higher than usual, widely spaced labia (due to the wide spacing of their pubic bones), and a clitoris formed in two halves with a split in the middle.