Epispadias
Epispadias is a rare congenital (present from birth) defect in which the opening of the urethra is in an abnormal location.
In boys with epispadias, the urethra generally opens on the top or side, rather than the tip, of the penis, though it is possible for the urethra to be open the entire length of the penis. In girls, the opening is usually between the clitoris and the labia but may be in the abdomen.
The causes of epispadias are unknown at this time. It is believed to be related to improper development of the pubic bone. Epispadias is often associated with bladder exstrophy. However, it can also occur alone or with defects other than exstrophy.
Epispadias occurs in 1 in 117,000 newborn boys and 1 in 484,000 newborn. It occurs when the genital tubercle develops more dorsally than is usual. The result is a urogenital sinus which opens on the dorsal surface of the penis. As such, urine is not expelled from the tip but rather from the root of the penis.
Epispadias Symptoms & Signs
In males:
Abnormal opening from the pubic symphysis to the area above the tip of the penis
Bladder exstrophy (may or may not be present)
Widened pubic bone
Short, widened penis with chordee (abnormal curvature of the penis)
Urinary incontinence
Reflux nephropathy
Urinary tract infections
In females:
Abnormal opening from the bladder neck to the area above the normal urethal opening
Bladder exstrophy (may or may not be present)
Widened pubic bone
Bifid clitoris, rudimentary labia
Urinary incontinence
Reflux nephropathy
Urinary tract infections
Surgical repair of epispadias is recommended for epispadias treatment. Leakage of urine (incontinence) is not uncommon and may require a second operation. |
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