Epispadias is a rare congenital anomaly that is almost always associated with bladder exstrophy.
It occurs in 1 in 30,000 births, with a male: female ratio of 3:1.
In males, three types are described - glandular, penile and complete. Glandular form is most common, and urethra opens on dorsum of penis, just behind glans. In penile form, the opening may be anywhere along penile shaft, however, most commonly seen at the base of the penis.
The roof of the urethra is absent and the urethra opens anywhere between the base and the glans of the penis.
In females, three types are described - clitoric, subsymphyseal and complete.
In complete forms of epispadias, incontinence is always seen due to sphincter involvement and is also associated with small bladder capacity.
- exstrophy-epispadias complex (EEC): represents a spectrum of genitourinary malformations ranging in severity from epispadias to classical bladder exstrophy and exstrophy of the cloaca.
Epispadias is a clinical presentation, and does not need a radiological diagnosis. However, bladder exstrophy features need to be well understood in this regard.
Treatment and prognosis
A Mitrofanoff procedure in an option in selected cases.
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