Epispadias

Urogenital Surgery

MTF Surgery

FTM Surgery

News

Epispadias in males is congenital anomaly which is characterized by short phallus with upward curvature (dorsal chordee). The glans lies open and flat like a spade, and the dorsal component of the foreskin is absent. The urethral opening is located on the dorsal penile shaft, anywhere between the penopubic angle and the proximal margin of the glans. Proximal forms are common and associated with incontinence.

In females the mons pubis is often deficient; the clitoris is bifid with divergent labia superiorly. The bladder neck opens at the level of the hymeneal ring, which is intact in most cases. Vaginal introitus is stenotic and lies anteriorly. Incontinence is common. In both cases, epispadias is often associated with bladder extrophy, so called epispadias-extrophy complex.

The goals of surgical procedures are to correct the curvature, to reconstruct the missing portion of urethra and to restore the normal aspect of the external genitalia. Repair depends on the position of epispadiac meatus and presence of incontinence. Surgical repair involves separation of the penis into its anatomical entities (total disassembly technique) and their reconstruction into normal anatomical relations, after urethral plate tubularisation. Streightening of the erectile bodies is of essential importance during surgical correction. Each case needs individual approach because of the wide spectrum of findings.

Case 1 Epispadias redo surgery (click image for larger view)