Shabaninia M, et al. - An appraisal was executed of the state of autophagy and its interactions with apoptosis and cell proliferation in patients who underwent successful early closure or delayed closure of exstrophy. Up-regulated autophagic process and increased apoptotic indices were reported in patients with small bladder template and delayed closure while experiencing a dramatic decrease in the proliferation of their bladder smooth muscle cells (SMC). The manipulation of autophagy could give rise to promising consequences for bladder exstrophy (BE) patients in the future.