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Journal articles on the topic 'Epispadia'

Author: Grafiati

Published: 7 September 2021

Last updated: 9 March 2023

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1

Soloviev, A. E. "EPISPADIAS IN GIRLS." Russian Journal of Pediatric Surgery 23, no. 3 (July 12, 2019): 166–68. http://dx.doi.org/10.18821/1560-9510-2019-23-3-166-168.

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Purpose. To study the clinical picture, diagnosis and treatment of epispadias in girls. Material and methods. 22 girls with epispadias of various forms were under supervision for 50 years. During diagnostics the following issues were used: anamnesis, examination, catheterization and uroflowmetry, cystoscopy of the bladder, ultrasound and X-ray examination. Results and discussion. Out of 22 girls with epispadias, clitoral epispadia (partial ) was in 10 patients; sub-symphisal (subtotal) - in 4; symphisal (total) - in 8 girls. In 10 girls with the clitoral form, urological examination was made because of changes in the urine. Girls with sub-symphisal epispadia complained of irritation and itching in the vulva. All had vulvitis, cystitis, chronic pyelonephritis. In 2 patients, renal doubling was diagnosed; in other 2 patients ureterohydronephrosis and kidney dystopia were diagnosed. Uroflowmetry revealed hyperactive bladder in all. 8 girls with the total (symphisial) form of epispadia and urinary incontinence were operated by the Derzhavin technique; after the surgery the function of bladder sphincter was restored and the patients could have a normal quality of life. Conclusion. Epispadia in girls is a rare case . There are clitoral, sub-symphisal and symphisal (total) forms of epispadias. Cluster and sub-symphisial forms do not require surgical treatment. While in the symphisial (total) form, plastic surgery on the bladder neck by the Derzhavin technique is recommended. It is a good option for recovery.

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2

Perovic, S. "Progressi nella chirurgia della epispadia." Urologia Journal 65, no. 3 (June 1998): 404. http://dx.doi.org/10.1177/039156039806500316.

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3

Macedo, Antonio, Marcela Leal da Cruz, Rodrigo Trivelato, Gilmar Garrone, Bruno Leslie, Diego Estevam Oliveira, Geórgia Rubiane Souza, and Valdemar Ortiz. "Complete female epispadia: The case for perineal approach." Journal of Pediatric Urology 11, no. 1 (February 2015): 49–50. http://dx.doi.org/10.1016/j.jpurol.2014.08.013.

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4

RABOCH, J. "Incidence of Hypospadia and Epispadia in Chromatin-positive Men." Andrologia 7, no. 3 (April 24, 2009): 237–39. http://dx.doi.org/10.1111/j.1439-0272.1975.tb00935.x.

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5

Tirtayasa, Pande Made Wisnu, Robertus Bebet Prasetyo, and Arry Rodjani. "Diphallia with Associated Anomalies: A Case Report and Literature Review." Case Reports in Urology 2013 (2013): 1–4. http://dx.doi.org/10.1155/2013/192960.

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Diphallia or penile duplication is an extremely rare congenital anomaly. It occurs once in every 5.5 million live births. The extent of penile duplication and the number of associated anomalies vary greatly, ranging from a double glans from a penis with no associated anomaly up to complete penile duplication associated with multiple anomalies. Here, we report a 12-year-old boy with complete bifid diphallia associated with bifid scrotum, epispadia, and pubic symphysis diastasis along with a review of the articles pertaining to this anomaly.

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6

Holmdahl, Gundela, Michaela Dellenmark-Blom, Agneta Nordenskjöld, and Sofia Sjöström. "Health-Related Quality of Life in Patients with the Bladder Exstrophy-Epispadias Complex and Relationship to Incontinence and Sexual Factors: A Review of the Recent Literature." European Journal of Pediatric Surgery 30, no. 03 (June 2020): 251–60. http://dx.doi.org/10.1055/s-0040-1713178.

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AbstractThe bladder exstrophy-epispadia complex (BEEC) includes malformations with midline closing defects of the lower abdomen and external genitalia. Long-term consequences with urinary incontinence and sexual dysfunction, in spite of multiple surgical interventions, are common and expected to affect the patient's health-related quality of life (HRQOL). The extent and the predictive factors are, however, not known. New patient-reported outcome research is emerging, but valid and reliable condition-specific HRQOL are still missing. The aim of this review is to summarize and discuss the latest published reports (2015–2019) on HRQOL in patients with the BEEC and its relationship to incontinence and sexual factors.

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7

Filho, Luiz G. Freitas, Cassius M. Silva, Karine F. Meyer, Fernando S. Rios, Felipe Toledo, and Luiz J. Budib. "Abdominal flap for penis augmentation in extrophy-epispadia complex: A case report." Pediatric Urology Case Reports 6, no. 2 (March 1, 2019): 42–45. http://dx.doi.org/10.14534/j-pucr.2019249356.

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8

Carmignani, G., S. De Stefani, C. Corbu, F. Pirozzi Farina, and S. Poddighe. "Epispadia Completa Sottosinfisaria Con Incontinenza Totale Di Urine E Malformazione Dei Genitali Esterni." Urologia Journal 52, no. 2 (April 1985): 208–13. http://dx.doi.org/10.1177/039156038505200212.

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9

Aniuliene, Rosita, Povilas Aniulis, Vitalija Druktenyte, and Birute Zilaitiene. "Surgical treatment of stress urinary incontinence and vaginal prolapse for the woman with epispadia." Open Medicine 9, no. 6 (December 1, 2014): 807–10. http://dx.doi.org/10.2478/s11536-013-0332-9.

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AbstractPatient K.L., 32 years old. Menses started at thirteen years old, C 5/28. Patient had two vaginal deliveries in 2004 and 2010. Dysplasia cervicis uteri CIN2-3 was diagnosed in 2007, subsequently diathermoconisation cervicis uteri was performed. The woman was born with epispadia — extrophia of urethra to abdominal wall, without pubic bone. At the age of 8 she underwent an operation in Moscow. During the operation the neck of the bladder was formed as well as urethra, which opens in vulva, place of clitoris. When she was 8 years old, her bladder capacity was 30 ml, in teenage years — 90 ml. The patient also reported history of recurrent urinary tract infections. 2011.08.02 Patient took medical advice in out patient department Kaunas university hospital with a complaint of stress urinary incontinence: when going, coughing, sneezing, doing exercises, having sex and at rest of time. Also it was the sexual intercourse problems with orgasm. She was urinating 8 times per day but none at night. Gynecological examination: absence of pubic bone, vulva is abnormal: absence of labium major and clitoris. Urethra opens into the place of clitoris. Front and back walls of vagina are moving down (POP-Q II-III stage prolapsed). Cervix of uterus is short, epithelised (after diathermoconisation). Uterus is normal in size, in retro-versio-flexio position. — without pathology. Sonography: internal genital organs without pathology. Boney, Valsalva test are positive, Ulmstein test negative. Urodynamic study revealed a bladder capacity of 134 ml, voided volume 173 ml. Pressure of detrusor — 10cmH2O. Compliancenormal, max flow rate 13,8 ml/s, voiding time 24 s. Spontaneous contractions of detrusor were not observed. Surgical treatment: 2011.10.10 TOT (tension obturator tape). Anterior and posterior colporrhaphy and perineoplastic was performed. There were no complications during and after surgery. On the 2 day after operation patient was released from hospital.

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10

Ali, Rao Nouman, Khalid Hussain, Hassam Khalid, Zain Yasin, and Attiq-ur Rehman. "A case report on continent isolated male epispadias." Professional Medical Journal 27, no. 06 (June 10, 2020): 1320–22. http://dx.doi.org/10.29309/tpmj/2020.27.06.3899.

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Epispadias is a rare congenital anomaly in which the urethral opening is on the dorsal surface of penis. Its incidence is 1 in 117000 newborn males and 1 in 484000 in newborn females. Its etiology is considered as because of failure of medial migration of mesenchyme between the ectodermal and endodermal layers of cloacal membrane due to premature rupture of cloacal membrane. Epispadias often presents as exstrophy epispadias complex, a wide spectrum of abnormalities that consist of classic bladder exstrophy, Epispadias and cloacal exstrophy. This case was not a part of exstrophy epispadias complex and it was an isolated continent epispadias which is extremely rare and it was managed with Cantwell Ransley epispadias repair technique.

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11

Bodnar, O. B., B. M. Bodnar, A. V. Irinchin, I. I. Pasternak, and R. Yu Randiuk. "Complete duplication of the urethra in a boy with epispadias." Paediatric Surgery. Ukraine, no. 3(72) (September 29, 2021): 84–88. http://dx.doi.org/10.15574/ps.2021.72.84.

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Duplication of the urethra is a rare abnormality that can occur with other urogenital tract congenital pathologies. Ischemia at embryogenesis, urogenital sinus defect, Muller`s duct anomaly and incomplete mesodermal fusion are the pathophysiological mechanisms of the pathology onset. Duplication of the urethra diagnostics is based on clinical examination, disease anamnesis, urethrography and magnetic resonance imaging. It is nessessary to consider Effmann and Leibowitz classification, urethras and prostate location and urethral orifice distance on operation of additional urethra removing. Clinical case. Presenting a clinical case of a boy with grade I epispadias and complete duplication of the urethra. Urination was maintained and was performed from the dorsal-epispadic urethra, the ventral urethra was obliterated in the distal region. According to the data of magnetic resonance imaging: double urethra is traced, dorsal – comes out from the anterior parts of the bladder wall, continues along the dorsal surface under the dorsal neurovascular bundle, above the cavernous bodies. The urethra opening is traced at the level of the upper surface of the head of the penis. The distal / ventral urethra comes out from the posterior parts of the lower bladder wall, typically continues down through the prostate embryo, rotated forward between of the corporas cavernosas stipes, and had a typical location with except for the level of the penis head, where it bends and merges with the dorsal urethra, which opens with a single opening. The surgery of excision of an additional urethra on child was performed. During the examination of the child of 6 months after surgery: urination with one stream from the ventral urethra at the apex of the head of the penis, stream freely passes the Nelaton catheter No. 10, child holds urine, there was no complaints. Performing of the next stage of the operation (penis plastic surgery) is planned after 1 year of the previous stage. Conclusions. In cases of epispadias is possible a congenital defect – a complete douplication of the urethra with the ventral urethra obliteration at the top of the head, which may not be determined in epispadias surgery preparation. Doubling of the urethra in boys requires magnetic resonance imaging for a better orientation in the defect anatomy and to determine the tactics of further surgical treatment. The research was carried out in accordance with the principles of the Helsinki declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: complete duplication of the urethra, surgical treatment, children.

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12

Nadhir, Ahmad, and Tarmono Tarmono. "Modified Cantwel-Ransley Reconstruction of Continent Penile Epispadias In Children: A Case Report." Folia Medica Indonesiana 57, no. 3 (September 5, 2021): 262. http://dx.doi.org/10.20473/fmi.v57i3.24357.

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Epispadias as an isolated embryologic defect is a rare anomaly, with an incidence of 1 in 117.000 males. Isolated epispadias with continence is a very rare condition comprising less than 10% of all epispadias cases. Epispadias is a closure defect of the dorsal wall of the urethra. The biggest challenges for epispadias treatment are creating adequate penile length, straightening the severely curved penis, and creating a penopubic angle for allowing comfortable penetration of the penis. An 11-year-old boy underwent surgery for his continent penile epispadias in Dr. Soetomo General Academic Hospital. The surgical technique chosen for this patient was Modified Cantwell-Ransley repair. The dressing was opened on the 3rd day after the operation. The urethral catheter was removed on the 10th day. The patients underwent regular follow-up examinations for 6 months and were evaluated for subjective and objective outcomes. There was no post-operative fistula or urethral narrowing requiring urethral dilatation. The Uroflowmetry and post voiding residual ultrasound result was good. The cosmetic appearance of the penis was satisfying. Outcomes related to sexual activity were not evaluated because the patient had no sexual activity yet.

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13

Sarma, Vivek Parameswara. "Concealed epispadias: a rare anomaly - case report and review." International Surgery Journal 6, no. 8 (July 25, 2019): 2979. http://dx.doi.org/10.18203/2349-2902.isj20193353.

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Epispadias with an intact prepuce (Concealed Epispadias) is an uncommon anomaly. The specific clinical signs in this situation are broad, spade-like glans with a dorsally directed preputial opening, gap between the corpora cavernosa may be palpable, dorsal chordee and abnormalities of the penile raphae. We report the case of a 3 year old male child with Concealed Epispadias who underwent a modified Cantwell-Ransley operation with good outcome. The relevant anatomy, embryology and surgical options are reviewed.

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14

Spinoit, Anne-Francoise, Tom Claeys, Elke Bruneel, Achilles Ploumidis, Erik Van Laecke, and Piet Hoebeke. "Isolated Male Epispadias: Anatomic Functional Restoration Is the Primary Goal." BioMed Research International 2016 (2016): 1–4. http://dx.doi.org/10.1155/2016/6983109.

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Background. Isolated male epispadias (IME) is a rare congenital penile malformation, as often part of bladder-exstrophy-epispadias complex (BEEC). In its isolated presentation, it consists in a defect of the dorsal aspect of the penis, leaving the urethral plate open. Occurrence of urinary incontinence is related to the degree of dorsal displacement of the meatus and the underlying underdevelopment of the urethral sphincter. The technique for primary IME reconstruction, based on anatomic restoration of the urethra and bladder neck, is here illustrated.Patients and Methods. A retrospective database was created with patients who underwent primary IME repair between June 1998 and February 2014. Intraoperative variables, postoperative complications, and outcomes were assessed. A descriptive statistical analysis was performed.Results and Limitations. Eight patients underwent primary repair, with penopubic epispadias (PPE) in 3, penile epispadias (PE) in 2, and glandular epispadias (GE) in 3. Median age at surgery was 13.0 months [7–47]; median follow-up was 52 months [9–120]. Complications requiring further surgery were reported in two patients, while further esthetic surgeries were required in 4 patients.Conclusion. Anatomical restoration in primary IME is safe and effective, with acceptable results given the initial pathology.

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15

Jonuzi, Asmir, Nusret Popović, Zlatan Zvizdić, Emir Milišić, Kenan Karavdić, and Paddy Dewan. "Female Epispadias Presenting as Urinary Incontinence." APSP Journal of Case Reports 8, no. 2 (March 21, 2017): 10. http://dx.doi.org/10.21699/ajcr.v8i2.548.

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Isolated female epispadias without bladder exstrophy is a rare congenital anomaly affecting 1 in 484,000 females. The presenting features of female epispadias are urinary incontinence and abnormal anatomical features. A 6-year-old girl presented with primary urinary incontinence who on physical examination had a bifid clitoris and labia minora. The vagina and hymen were normal. Voiding cystourethrogram showed no reflux and a funnel shaped proximal urethra. With the diagnosis of isolated female epispadias, one-stage reconstruction of the urethra, bladder neck, labia minora and clitoris was performed.

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16

Inouye, Brian M., Ali Tourchi, Heather N. Di Carlo, Ezekiel E. Young, and John P. Gearhart. "Modern Management of the Exstrophy-Epispadias Complex." Surgery Research and Practice 2014 (2014): 1–9. http://dx.doi.org/10.1155/2014/587064.

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The exstrophy-epispadias complex is a rare spectrum of malformations affecting the genitourinary system, anterior abdominal wall, and pelvis. Historically, surgical outcomes were poor in patients with classic bladder exstrophy and cloacal exstrophy, the two more severe presentations. However, modern techniques to repair epispadias, classic bladder exstrophy, and cloacal exstrophy have increased the success of achieving urinary continence, satisfactory cosmesis, and quality of life. Unfortunately, these procedures are not without their own complications. This review provides readers with an overview of the management of the exstrophy-epispadias complex and potential surgical complications.

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17

Husarić, Edin. "Female Epispadias in 10 Year Girl." Central European Journal of Paediatrics 18, no. 1 (March 12, 2022): 50–51. http://dx.doi.org/10.5457/p2005-114.316.

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18

Gite, Venkat Arjunrao, Hitesh Mahendra Jain, Sachin M. Bote, and Jayant Vijay Nikose. "Modified Cantwell–Ransley repair for isolated continent epispadias in adult: Our experience." Indian Journal of Plastic Surgery 50, no. 01 (January 2017): 068–73. http://dx.doi.org/10.4103/ijps.ijps_243_16.

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ABSTRACTPurpose: We evaluate here our experience with modified Cantwell–Ransley technique described by Gearhart for correction of isolated continent epispadias in adults with respect to its long-term functional outcome and complications. Introduction: Isolated male epispadias is a rare anomaly with a reported incidence of 1 in 11,700 males. Many surgical techniques with various modifications described to correct epispadias as treatment are debatable and challenging. The majority of the cases are treated at childhood as clinical presentation is striking at birth; hence, presentation in adulthood is extremely rare. Materials and Methods: During the past 5 years, modified Cantwell–Ransley technique described by Gearhart was performed in five cases of isolated continent epispadias which includes two cases of proximal penile, two distal penile and one penopubic. All cases were fresh except one had prior failed repair. Corporal rotation was done by delayed absorbable sutures without incision and anastomosis and suprapubic diversions placed in all the cases. Results: All cases followed up ranging from 6 months to 5 years and were having horizontal and downwards angled penis. No case had urethrocutaneous fistula or stricture. One case had superficial skin infection which healed by secondary intention did not require any secondary procedure. All cases maintained erection post-operatively too. Catheterisation with soft tube revealed easily negotiable channel in all cases on follow-up. Conclusion: Modified Cantwell–Ransley repair described by Gearhart has excellent cosmetic, functional and anatomical results in isolated continent epispadias in the adult.

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19

Ganarin, Alba, Michele Corroppolo, Giosuè Mazzero, Clara Revetria, Fabio Beretta, and Enrico Ciardini. "Exstrophy-Epispadias Complex Variants: A Hybrid Case." Pediatric Reports 13, no. 2 (April 7, 2021): 177–80. http://dx.doi.org/10.3390/pediatric13020024.

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The term exstrophy-epispadias complex refers to a group of midline defects ranging from epispadias to cloacal exstrophy. Bladder exstrophy is the most frequent malformation of this spectrum and it can present as a classical or a variant form. We report a case of a hybrid bladder exstrophy variant having some characteristics of both a duplicate bladder exstrophy and a superior vesical fistula.

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20

Demidov, Alexandr A., and Elena V. Mlynchik. "Effectiveness of urethral endosphincteroplasty in children with urinary incontinence, myelodysplasia, and epispadias." Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care 12, no. 3 (November 2, 2022): 337–50. http://dx.doi.org/10.17816/psaic1000.

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BACKGROUND: Periurethral injections of various materials in the treatment of stress urinary incontinence have been known since 1938. In the literature, we could not find reports of endosurgical correction of urinary incontinence as the main method of treatment in children with myelodysplasia and epispadias and a pathogenetically based examination algorithm to predict the result of the injection, taking into account the endoscopic technique and volume of the injected drug. AIM: To present an assessment of long-term results, i.e., correction of stress urinary incontinence in children with myelodysplasia and epispadias, after endoimplantation of a stable synthetic volume-forming polymer. MATERIALS AND METHODS: The study analyzed 38 patients (517 years old) with urinary incontinence with myelodysplasia and epispadias: boys and girls with epispadias (n = 9 and n = 3, respectively) and with myelodysplasia (n = 10 and n = 16), respectively. For diagnostic purposes, clinical and instrumental (excretory urography, cystography, cystoscopy, uroflowmetry, electrophysiological, and urodynamic) examination methods were used. To correct incontinence, intra- and paraurethral endoinjections of a stable polyacrylamide mesh polymer with silver ions were performed. RESULTS: According to the literature, the effectiveness of the intraurethral administration of stable implants with urinary incontinence in catamnesis for up to 12 months reached 50%; with longer follow-up, positive results did not exceed 40% of observations. In this study, complete retention of urine was achieved in 25 (66%) children. Satisfactory result (incontinence in the afternoon up to 40 mL) was observed in 8 (21%) children, and unsatisfactory in 5 (13%) children. DISCUSSION: Indications for endosphincteroplasty in children with stress incontinence having myelodysplasia and epispadias with a stable implant should be determined considering urodynamics, blood circulation, innervation, and functional (urethral profilometry) parameters in the detrusor-sphincters-pelvic floor system. CONCLUSIONS: In patients with myelodysplasia and epispadias with isolated insufficiency of urethral sphincters, surgical treatments can be performed independently, and their effectiveness can reach 70%.

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21

Kumar, Prashant, Rishi Nayyar, Amlesh Seth, and Deepti Gupta. "Management of cavernous abdominal wall defects post radical cystectomy in adult exstrophy complex." BMJ Case Reports 12, no. 1 (January 2019): bcr—2018–226076. http://dx.doi.org/10.1136/bcr-2018-226076.

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The exstrophy–epispadias complex represents a spectrum of genitourinary malformations ranging from simple glanular epispadias to an overwhelming multisystem defect, cloacal exstrophy. Neonatal total reconstruction of bladder exstrophy–epispadias complex is the treatment of choice. An adult patient presenting with untreated exstrophy is very rare. Malignant transformation, commonly adenocarcinoma, in such cases is a known complication due to mucosal metaplasia of urothelium. Management in such cases necessitates a radical surgical procedure that often results in a massive defect in the anterior abdominal wall. Providing a cover for such defects is a challenging task for the reconstructive surgeon. Local skin flaps and wide mobilisation of the rectus muscle are the usually employed techniques for closure of such defects. However, these may be inadequate in extremely large defects such as those encountered in our patients. We, hereby, describe our technique of closure of the abdominal wall defect using a pedicled anterolateral thigh flap.

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22

Krishna Shetty, MV, TK Sen, and VA Bhaskaran. "Female epispadias." African Journal of Paediatric Surgery 8, no. 2 (2011): 215. http://dx.doi.org/10.4103/0189-6725.86066.

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23

Mollard, P., T. Basset, and P. Y. Mure. "FEMALE EPISPADIAS." Journal of Urology 158, no. 4 (October 1997): 1543–46. http://dx.doi.org/10.1016/s0022-5347(01)64276-9.

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24

Diamond, David A., and Philip G. Ransley. "Male Epispadias." Journal of Urology 154, no. 6 (December 1995): 2150–55. http://dx.doi.org/10.1016/s0022-5347(01)66719-3.

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25

Hafez, Ashraf T. "Epispadias repair." Current Opinion in Urology 22, no. 6 (November 2012): 457–61. http://dx.doi.org/10.1097/mou.0b013e3283589793.

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Apicella, Andrea, Pierluigi Marzuillo, Rosaria Marotta, and Angela La Manna. "Female Epispadias." Journal of Pediatrics 167, no. 5 (November 2015): 1164. http://dx.doi.org/10.1016/j.jpeds.2015.08.001.

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27

Shenage, Vinayak J., Sanjay P. Dhangar, Awais A. Syed, and Manisha Shengal. "The impact of classic bladder exstrophy-epispadias repair in adult patients without continence." International Surgery Journal 8, no. 8 (July 28, 2021): 2366. http://dx.doi.org/10.18203/2349-2902.isj20213130.

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Background: Bladder exstrophy-epispadias complex is a rare congenital anomaly. Very few patients grow with the condition intact in their adulthood which lead to compromise in the results of repair. We herein report our experience of correction of the defects in the adult patients in single stage without doing osteotomy andurinary diversion. Methods: The sample size was 13 patients over ten years. All were treated in single stage. Bladder neck repair was done using paraurethral tissue, primary abdominal closure was done without flap, epispadias repair was done using modified Cantwell-Ransley procedure and hernial repair was done without mesh. No osteotomy was done. All the patients were followed regularly. Minimum period of follow-up was one year. Urinary continence, change in habits and subjective assessment of well-being were also noted.Results: 86.4% patients were totally incontinent. Bladder and anterior abdominal wall were closed in all the patients. Complete epispadias was possible in15.3% patients and rest were converted into coronal hypospadias. Hernia was repaired in 23% patients. All the patients were satisfied with their cosmetic results and they were able to interact socially. Conclusions: Surgical correction of the exstrophy-epispadias complex is possible in adulthood in the hands of experts in single stage without osteotomy. Regular cystoscopic examination and urine cytology yearly are recommended to diagnose the malignant changes in the native bladder as early as possible. Psychological, social and self-level of satisfaction is high among these patients after the surgical correction.

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Dihtiar, V. A., D. H. Vernihora, L. M. Haritoniuk, M. V. Boyko, and A. V. Obertynskyi. "Clinical case of urethral doubling with preservation of function and single bladder." Paediatric Surgery. Ukraine, no. 2(75) (June 25, 2022): 101–4. http://dx.doi.org/10.15574/ps.2022.75.101.

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Urethral doubling is a rare congenital anomaly of the urinary system that is more common in boys. Less than 500 clinical cases of this disease have been described in the literature, which may signal a lack of awareness among physicians. Although there are many considerations regarding the embryology of this anomaly, the etiopathogenesis of its various forms remains unclear. Sometimes doubling of the urethra is combined with other malformations, such as epispadias, hypospadias, exstrophy of the bladder, anorectal malformation, doubling of the bladder and others. In this article, we present a clinical case of a 9-year-old boy with urethral duplication and additional urethral epispadias. We found the main and additional urethra, which goes on dorsal side of the penis and led to curvature of the penis and urinary incontinence. During the operation, urethrocystoscopy was performed before the main stage, and a complete doubling of the type 2-A urethra was established according to the Effman classification, after which the additional urethra was excised as far as the pubic bones. Urethral duplication is a rare anomaly, with several forms of clinical presentation, often accompanied by other anomalies, and sometimes with difficult diagnosis. The treatment of urethral duplication should be individualized, according to its type. In this case we find urethral duplication type IIa, which has been treated as classic epispadias. Therefore, in child with congenital malformation of penis need to perform obsrvetion like urethrography, cystoscopy. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors. Key words: urethral substitution, epispadias.

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29

Khan, Md Shaukat Ali. "Complete Urethral Duplication With Epispadias in a Young Man: A Case Report." Bangladesh Journal of Urology 21, no. 1 (October 15, 2020): 48–51. http://dx.doi.org/10.3329/bju.v21i1.49763.

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A 25 year male patient presented with the complaints of passage of urine through two openings on his penis, with deformities of penis since birth. After birth his parents noticed, when he micturates, urine comes through an opening on the proximal part of dorsal surface of penis in addition to the opening on the tip of glans penis. The penis is also a bit deformed and dorsal part of corona glandis is bifid. No treatment for the anomaly was taken. At puberty his testes, scrotum and other secondary sexual characteristics developed normally. He feels sexual attractions to opposite sex and experiences nocturnal emissions periodically. His penis erects on sexual stimulations, but bends upwards and at the peak of excitement orgasm also occurs and semen comes through the ventral orthotopic opening only. General physical examination was unremarkable, but external genitalial examination, shows, two external urethral meatus – one small pit like opening at the normal orthotopic position on the tip of glans penis and another on the dorsal surface of proximal penile shaft with epispadias and exposed urethral plate distal to this.. He had also dorsal chordee and ventral hooding with dorsal bifid glans penis. He had normally developed scrotum with normal both testes . Corpora cavernosa are developed but separated proximally. Spongiosa also developed and orthotopic anterior urethra can be palpated. Other systemic examinations revealed no abnormalities. Routine investigations like urine R/E, C/S, S.creatinine, blood sugar, CBC were normal. X-ray KUB revealed small separation of pubic symphysiis. USG of whole abdomen with KUB revealed significant PVR (77cc) with features of cystitis (sediments in bladder) with no other abnormality. RGU and MCU revealed duplicated urethra –with an accessory urethra arising from bladder neck, runs above the orthotopic one along the shaft terminating at the proximal part of dorsal penile shaft. The lower orthotopic urethra is normal with no stricture or abnormality except narrowing of the distal anterior urethra and external opening. Cystogram shows normal bladder with no VUR or divarticula except thickend wall. Urethrocystopic examination after dilatation of stenosed EUM of orthotopic (ventral) urethra showed normal anterior and posterior urethra containing sphincter and verumotanum and prostatic urethra opening into the bladder neck. Then cystoscope passed through the dorsal epispadiac urethra , which showed a less developed urethra, opening into the protruding bladder neck. Urinary bladder and ureteric orifices were normal . Then excision of accessory epispadiac urethra and the urethral plate done as high as possible near to bladder neck, followed by correction of chordee by ventral plication and repair of bifid corona glandis. He had an uneventful recovery ,though having a residual dorsal chordee, which was corrected by a second operation after 18 months, when excision of residual stump of accessory dorsal urethra followed by dermal graft repair of dorsal corporal body done. Bangladesh Journal of Urology, Vol. 21, No. 1, January 2018 p.48-51

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30

Mahajan, J. K., Sunita Ojha, and K. L. N. Rao. "Pseudoexstrophy with Epispadias." Urologia Internationalis 74, no. 4 (2005): 365–67. http://dx.doi.org/10.1159/000084440.

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31

Brzezinski, Alex E., Yves L. Homsy, and Ivan Laberge. "Orthoplasty in Epispadias." Journal of Urology 136, no. 1 Part 2 (July 1986): 259–61. http://dx.doi.org/10.1016/s0022-5347(17)44833-6.

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32

Grady, Richard W., and Michael E. Mitchell. "Management of epispadias." Urologic Clinics of North America 29, no. 2 (May 2002): 349–60. http://dx.doi.org/10.1016/s0094-0143(02)00027-7.

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33

Ebert, A. K., and K. Adamczyk. "Epispadie und Harnröhrenduplikatur." Der Urologe 54, no. 5 (May 2015): 634–40. http://dx.doi.org/10.1007/s00120-015-3792-5.

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34

Stuhldreher, Peter P., Brian Inouye, and John P. Gearhart. "Exstrophy-Epispadias Complex." Current Bladder Dysfunction Reports 10, no. 3 (August 9, 2015): 227–32. http://dx.doi.org/10.1007/s11884-015-0306-7.

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35

Ebert, Anne-Karoline, and Annette Schröder. "Hypospadie und Epispadie." Pädiatrie up2date 17, no. 04 (December 2022): 321–34. http://dx.doi.org/10.1055/a-1325-6162.

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36

Stephens, F. Douglas, and John M. Hutson. "Differences in embryogenesis of epispadias, exstrophy–epispadias complex and hypospadias." Journal of Pediatric Urology 1, no. 4 (August 2005): 283–88. http://dx.doi.org/10.1016/j.jpurol.2005.01.008.

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37

Borzi, P. A., and D. F. M. Thomas. "Cantwell-Ransley Epispadias Repair in Male Epispadias and Bladder Exstrophy." Journal of Urology 151, no. 2 (February 1994): 457–59. http://dx.doi.org/10.1016/s0022-5347(17)34989-3.

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38

Bajpai, Minu, Sachit Anand, and Prabudh Goel. "Single-Stage Trans-Vestibular and Foley’s-Assisted Epispadias Repair (STAFER) for Girls with Incontinent Epispadias: A Retrospective Study from a Tertiary-Care Center." Uro 2, no. 2 (April 20, 2022): 93–99. http://dx.doi.org/10.3390/uro2020011.

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Objective: The aim of this study was to evaluate the outcomes of single-stage trans-vestibular and Foley’s assisted epispadias repair (STAFER) technique in girls with incontinent epispadias. Methods: The records of all girls who had undergone epispadias repair and bladder neck plication via the STAFER technique over a four-year study period (January 2016 to December 2019) were retrospectively reviewed from the archives. A comparison of preoperative and postoperative functional outcomes was performed. Incontinence status was divided into four grades on the basis of severity: grade 0 (completely dry during day and night), grade 1 (occasional episodes of urine leakage leading to damp undergarments or requiring pads occasionally but not daily), grade 2 (frequent episodes of urine leakage with a dry period of <3 h), and grade 3 (completely incontinent). Renal bladder ultrasound (RBUS), micturating cystourethrogram (MCUG) scan, technetium-99m diethylenetriamine pentaacetate (DTPA) scan, and technetium-99m dimercaptosuccinic acid (DMSA) scan were performed to assess the upper tract function. Results: Nine girls with average (SD) age at surgery of 7.9 (3.8) years were operated on utilizing the STAFER technique during the study period. All cases had grade 3 incontinence and normal upper tracts prior to the surgery. Postoperatively, 8/9 girls had a dry period of more than 3 h. Six of them were completely dry and had no wetting episodes (grade 0 incontinence). DMSA and DTPA scans showed preserved upper tracts while MCUG scans revealed grade II VUR in only one case. Conclusions: In a limited cohort of girls with incontinent epispadias, the STAFER technique provides favorable functional outcomes in terms of continence and upper tract function. Further studies comprising a larger cohort of patients with a younger average age at surgery need to be conducted before definite conclusions regarding the efficacy of this technique are drawn.

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39

Di Giulio, Andrea, John D. Pinto, and Marco A. Bologna. "Larval morphology of the Neotropical genus Epispasta (Coleoptera, Meloidae)." Canadian Entomologist 137, no. 6 (December 2005): 657–71. http://dx.doi.org/10.4039/n04-105.

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AbstractThe first-instar (triungulin), second-instar, and third-instar larvae of the South American monotypic genus Epispasta Selander, 1960 are described and figured. The triungulin of E. abbreviata (Klug, 1825) is highly adapted for phoresy on bees and resembles the triungulins of several other phoretic genera in the subfamily Meloinae. The second- and third-instar larvae of Epispasta are unique in that they retain the campodeiform phenotype of the first instar. These instars in other meloid genera are scarabaeiform. A discussion is provided on the similarity of the triungulin of Epispasta to that of other phoretic meloines. We argue that this similarity is a result of morphological convergence correlated with phoretic behavior and is not evidence of a relationship. The position of Epispasta in Meloinae remains questionable, as none of its larval or adult features ally it to any other genus.

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40

Bhat, N., and I. Wani. "Female Epispadiasis: A Case report." Journal of Nepal Paediatric Society 31, no. 3 (September 20, 2011): 244–46. http://dx.doi.org/10.3126/jnps.v31i3.4415.

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Isolated female epispadias without exstrophy is rare to see. It is often overlooked cause of incontinence in a female child. A case of isolated female epispadias without exstrophy in an 11-year-old girl who presented with primary urinary incontinence since birth is reported. She had never had a genitalia examination done by any treating clinician. On examination, she had a bifid clitoris and ill developed labia minora. Voiding cystourethrogram showed small sized bladder with no reflux. Bladder neck reconstruction was done transvesically, with tubularisation of urethra. The case report reflects the importance of physical examination in primary incontinence which can make an early diagnosis and treatment and prevent stigmata of incontinence. DOI: http://dx.doi.org/10.3126/jnps.v31i3.4415 J Nep Paedtr Soc 2011;31(3): 244-246

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41

Gómez-Pamatz, Francisco Javier, Cristóbal Landa-Román, and Jorge Ignacio Tapia-Garibay. "Asociación entre hipospadias y criptorquidia con anquiloglosia y anquiloquilia en pacientes del Hospital Infantil de Morelia." Revista Mexicana de Urología 80, no. 4 (August 17, 2020): 1–10. http://dx.doi.org/10.48193/rmu.v80i4.489.

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Introducción: El estudio fue centrado en los diagnósticos de hipospadias, epispadias, fimosis y criptorquidia, buscando en ellos la presencia de anquiloglosia y/o anquiloquilia. Métodos: Estudio observacional, descriptivo, trasversal, sin riesgo. Se revisaron 50 pacientes que acudieron a revisión al servicio de urología pediátrica del Hospital Infantil de Morelia “Eva Sámano de López Mateos” (SSA), en un periodo comprendido de diciembre del 2017-agosto del 2018. Se incluyeron pacientes masculinos de 1-13 años que cumplieran la presencia de por lo menos dos criterios de evaluación. Se utilizaron las clasificaciones de Kotlow, Kayaba, hipospadias, epispadias y Beltrán Brown. Resultados: Se encontraron 50 pacientes diagnosticados con patologías de línea media que acudieron a consulta de urología. De los pacientes estudiados 68% tenían el diagnóstico de hipospadias, epispadias 0%, fimosis 12%, criptorquidia 10% e hipospadias con criptorquidia en un 10%. Aunado con la presencia de anquiloglosia patológica grado 3 en un 20%, anquiloglosia grado 4 un 12%. anquiloquilia labial superior grado 3 con 22% y grado 4 un 34%. y/o Anquiloquilia labial inferior grado 3 con 10% y grado 4 el 0%. Conclusión: Las alteraciones morfológicas de la línea media en el aparato reproductor masculino y la criptorquidia, presentan una íntima relación en las patologías dismórficas de los repliegues mucosos de la línea media bucal.

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42

Gómez-Pamatz, Francisco Javier, Cristóbal Landa-Román, and Jorge Ignacio Tapia-Garibay. "Asociación entre hipospadias y criptorquidia con anquiloglosia y anquiloquilia en pacientes del Hospital Infantil de Morelia." Revista Mexicana de Urología 80, no. 4 (August 17, 2020): 1–10. http://dx.doi.org/10.48193/revistamexicanadeurologa.v80i4.489.

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Introducción: El estudio fue centrado en los diagnósticos de hipospadias, epispadias, fimosis y criptorquidia, buscando en ellos la presencia de anquiloglosia y/o anquiloquilia. Métodos: Estudio observacional, descriptivo, trasversal, sin riesgo. Se revisaron 50 pacientes que acudieron a revisión al servicio de urología pediátrica del Hospital Infantil de Morelia “Eva Sámano de López Mateos” (SSA), en un periodo comprendido de diciembre del 2017-agosto del 2018. Se incluyeron pacientes masculinos de 1-13 años que cumplieran la presencia de por lo menos dos criterios de evaluación. Se utilizaron las clasificaciones de Kotlow, Kayaba, hipospadias, epispadias y Beltrán Brown. Resultados: Se encontraron 50 pacientes diagnosticados con patologías de línea media que acudieron a consulta de urología. De los pacientes estudiados 68% tenían el diagnóstico de hipospadias, epispadias 0%, fimosis 12%, criptorquidia 10% e hipospadias con criptorquidia en un 10%. Aunado con la presencia de anquiloglosia patológica grado 3 en un 20%, anquiloglosia grado 4 un 12%. anquiloquilia labial superior grado 3 con 22% y grado 4 un 34%. y/o Anquiloquilia labial inferior grado 3 con 10% y grado 4 el 0%. Conclusión: Las alteraciones morfológicas de la línea media en el aparato reproductor masculino y la criptorquidia, presentan una íntima relación en las patologías dismórficas de los repliegues mucosos de la línea media bucal.

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43

Gearhart, John P., Christopher Sciortino, Jacob Ben-Chaim, Dennis S. Peppas, and Robert D. Jeffs. "The Cantwell-ransley epispadias repair in exstrophy and epispadias: Lessons learned." Urology 46, no. 1 (July 1995): 92–95. http://dx.doi.org/10.1016/s0090-4295(99)80167-8.

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44

SURER, ILHAMI, LINDA A. BAKER, ROBERT D. JEFFS, and JOHN P. GEARHART. "COMBINED BLADDER NECK RECONSTRUCTION AND EPISPADIAS REPAIR FOR EXSTROPHY-EPISPADIAS COMPLEX." Journal of Urology 165, no. 6 Part 2 (June 2001): 2425–27. http://dx.doi.org/10.1016/s0022-5347(05)66220-9.

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45

ÖZDEN, Ender, Yakup BOSTANCI, Kamil Y. YAKUPOĞLU, Mehmet N. MERCİMEK, and Şaban SARIKAYA. "Epispadias Presenting as a Concealed Penis: Case Report." Turkiye Klinikleri Journal of Medical Sciences 33, no. 2 (2013): 557–59. http://dx.doi.org/10.5336/medsci.2011-25160.

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46

PEROVlC̀, S., D. ŠČEPANOVIC̀, D. SREMČEVIC̀, and V. VUKADINOVIC̀. "Epispadias Surgery-Belgrade Experience." British Journal of Urology 70, no. 6 (December 1992): 674–77. http://dx.doi.org/10.1111/j.1464-410x.1992.tb15842.x.

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47

Mouriquand, P., and I. Vidal. "Complejo extrofia-epispadias (CEE)." EMC - Urología 44, no. 3 (September 2012): 1–18. http://dx.doi.org/10.1016/s1761-3310(12)62022-2.

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48

Da Justa, Daniel G., Thomas G. Mueller, John P. Gearhart, and Joseph G. Barone. "REPAIR OF GLANDULAR EPISPADIAS." Journal of Urology 179, no. 4S (April 2008): 305–6. http://dx.doi.org/10.1016/s0022-5347(08)60892-7.

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49

Snow, Brent W., and Patrick C. Cartwright. "Cosmetic epispadias skin coverage." Urology 43, no. 2 (February 1994): 232–34. http://dx.doi.org/10.1016/0090-4295(94)90051-5.

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50

Farrell, Roy W. R., and Anthony L. Sparnon. "Complete epispadiac urethral duplication." Journal of Pediatric Surgery 22, no. 2 (February 1987): 175–76. http://dx.doi.org/10.1016/s0022-3468(87)80442-6.

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