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epispadias

Epispadias

Epispadias is a congenital abnormal urethral opening on the dorsal surface of penis.

Classification of epispadias

1. Anterior epispadias with normal continence 

Glanular; positioned of glans

Penile; shaft if penis


2. Posterior epispadias associated with incomplete bladder neck and incontinence of urine

Penopubic; near pubic bone at base of penis

In female child

1. Bifid clitoris with no incontinence of urine.

2. Subsymphyseal (urethral opening beneath symphysis pubis) with incontinence of urine.

Management

1. Reconstructive procedure

a. Penile lengthening, elongation of urethral strip and chordae correction.

b. Bladder neck reconstruction and correction of VUR (Vesico- urethral reflux).

2. Cytoplasty

Enhance bladder capacity



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