A 6-year-old female patient with a diagnosis of cloacal exstrophy who had undergone surgery on several occasions in different institutions; at the time of consultation she presented with multiple fistulas and scars on the abdominal wall with a significant deficit of antero-superior abdominal tissue. Due to the previous failure in the creation of a bladder reservoir, reconstruction is programmed, operating as a team with the Paediatric Urology Service.

1st surgical stage:
Consisted in the placement of 2 rectangular expanders of 1000cc. and 15,2cm. long x 7, 3cm wide with remote valve (Silimed®) below the abdominal cellulo-fatty tissue and above the aponeurosis of the greater oblique muscle in subcostal and lateral position. Between 50 to 100cc of saline were infiltrated at intervals of 1 week to 20 days, according to the patient's tolerance, until a volume of 1150cc was reached.

2nd Surgical time:
Once the expansion was completed, the expanders were removed and the ileocecal urinary reservoir was reconstructed, after which the abdominal defect was reconstructed by lifting and cross-linking two major oblique flaps, with a rotation axis in the lower ribs, which were covered with the expanded fascio-cutaneous tissues.

The patient evolved favourably without complications.
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