Cloacal exstrophy is a rare birth defect in which the bladder is exposed and the abdominal wall is not completely closed. It is a complex condition that affects the urinary, reproductive, and gastrointestinal systems. The bladder is split into two halves, and the intestines and reproductive organs are exposed. In some cases, the bladder may be connected to the intestines, forming a single opening called a cloaca. Treatment typically involves reconstructive surgery to close the abdominal wall and separate the bladder and intestines.