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Journal articles on the topic 'Epispadias'

Author: Grafiati

Published: 4 June 2021

Last updated: 27 July 2024

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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

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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3

Kagantsov, I. M., E. A. Kondratieva, N. A. Kohreidze, E. V. Komlichenko, and T. M. Pervunina. "One-stage correction of epispadia to Macedo in a girl 3 years old." Russian Journal for Personalized Medicine 3, no. 2 (May 20, 2023): 119–26. http://dx.doi.org/10.18705/27823806-2023-3-2-119-126.

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Introduction. Epispadias is an extremely rare disease. Epispadias in women is 5–6 times less common than in men. The incidence of female epispadias ranges from 1 in 160,000 to 480,000 live births. Epispadias can be diagnosed by a thorough examination of the genitals. Treatment of epispadias is only surgical, which is quite difficult and requires experience. The literature that discusses female epispadias is very limited. In this article, we would like to report on the surgical treatment of isolated epispadias in a 3-year-old girl at the Almazov National Medical Research Center.Clinical case. A 3-year-old girl presented with the main complaint of urinary incontinence since birth, during the day and at night. Urinary incontinence was not caused by physical activity and was not aggravated by eating/drinking. Physical examination showed that the external genital organs of the patient have underdeveloped labia minora, abnormal urethra, bifurcated clitoris. Laboratory results were within the normal range. Voiding cystourethrography revealed urine leakage during the filling phase. The bladder wall was normal, there was no vesicoureteral reflux. The patient underwent simultaneous surgical interventions, consisting in plastic surgery of the urethra and reconstruction of the bladder neck, plastic surgery of the clitoris and labia minora. There were no intraoperative and postoperative complications. After 1 week and 6 months of observation, the patient achieved urinary retention, the surgical wound healed primarily.Discussion. Epispadias is a rare condition that can vary in severity from mild to severe. Severely, splitting of the entire urethra occurs, involving the bladder neck, causing permanent urinary incontinence in the patient. Cases of epispadias are quite difficult to diagnose. The doctor should dilute the labia majora and carefully conduct a physical examination. The objective goals of the surgical treatment of epispadias are to achieve urinary retention, restore the anatomy, function and cosmetic appearance of the urethra and genitals. One-stage reconstruction is a modern surgical technique used to treat isolated epispadias in women.Conclusion. Epispadias in women is a rare congenital anomaly that is often not detected in childhood. For isolated epispadias in a girl, one-stage surgical correction is currently preferred.

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4

Atim T., Akpamgbo C. N., Eniola S. B., Aisuodionoe-Shadrach O. I., and Eze G. C. "Isolated Male Epispadias with Continence in a 40 Year Old: A Case Report." International Journal of Medical and Pharmaceutical Case Reports 16, no. 4 (December 28, 2023): 105–11. http://dx.doi.org/10.9734/ijmpcr/2023/v16i4359.

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Epispadias is part of the bladder exstrophy-epispadias complex; it has a defective dorsal wall of the urethra with potential incompetence of the urinary continence mechanism. Isolated male epispadias is due to failure of the urethral plate to tubularize on the dorsum of the penis. It is rare with an incidence rate of 1 in 117,000 live births in males. The severity depends on the position of the urethral opening and ranges from peno-pubic to penile and glandular. Epispadias is usually repaired within the first year of life though some patients have presented in their second decade. Epispadias is classically associated with bladder exstrophy in over 90% of the cases while isolated epispadias with continence is very rare constituting less than 10% of cases. Separation of pelvic bones is seen in 70% of peno-pubic epispadias affecting the bladder neck and external sphincter leading to incontinence and stress urinary dribbling. The goals of repair include; achieving a cosmetically acceptable and functional penis, which is straight and adequate in length, enabling penetrative sexual intercourse and urinary continence. There have been reports of isolated epispadias in adults but none was as old as 40 years. This patient has been married for 20 years and has been unable to impregnate his spouse. He had modified Cantwell-Ransley procedure after a detailed clinical and psychological evaluation to achieve the goals of repair. Adults presenting with isolated continent peno-pubic epispadias are rare. Presenting at this age and after having been married for two decades could have a derogatory effect on body image, self-confidence, psycho-sexual and reproductive life. Surgical correction of this anomaly as we did has the potential to lead to acceptable outcomes as demonstrated in this index case.

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5

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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6

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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7

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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8

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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9

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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10

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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11

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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12

Sarin, YogeshKumar, and Arvind Sinha. "Concealed epispadias." Indian Journal of Urology 17, no. 2 (2001): 183. http://dx.doi.org/10.4103/0970-1591.20274.

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13

Sagade, SN, and DharmRaj Singh. "Female epispadias." Indian Journal of Urology 16, no. 2 (2000): 163. http://dx.doi.org/10.4103/0970-1591.22223.

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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

Bencic, Marko, Marta Bizic, Ivana Joksic, Borko Stojanovic, and Miroslav L. Djordjevic. "Isolated Male Epispadias Repair: Long-Term Outcomes." Life 14, no. 4 (March 28, 2024): 446. http://dx.doi.org/10.3390/life14040446.

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Isolated male epispadias is one of the most severe congenital genital anomalies that require surgical correction. The goals of the surgery are to reach good aesthetic and functional outcomes. The aim of this retrospective study was to analyze the long-term outcomes of surgical reconstruction of male epispadias. A total of 31 patients with a mean age of 17 years, who underwent surgical repair of isolated male epispadias from January 2000 to January 2015, were involved. The main outcome measures were defined as: aesthetic outcome, continence, postoperative complications, sexual function, and quality of life. The follow-up period ranged from 8 to 23 years, with an average of 14.4 years. Each patients underwent an average of 2.2 surgical procedures in this period. The most common postoperative complications were urethral fistula and residual curvature, in 22.6% and 12.9%, respectively. Satisfactory aesthetic outcome was reported in 71.4% of cases. The repair of male epispadias usually includes more than two procedures with satisfactory aesthetic outcome. Unsolved urinary incontinence remains a significant issue and has a high impact on the quality of life. Follow-up should be extended even after complete sexual maturity. Comprehensive long-term evaluation is necessary for proper treatment of isolated epispadias.

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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

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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20

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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21

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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22

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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23

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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24

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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25

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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26

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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27

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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28

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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29

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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30

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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31

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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32

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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33

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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34

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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35

Eeg, Kurt R., and Antoine E. Khoury. "The exstrophy-epispadias complex." Current Urology Reports 9, no. 2 (March 2008): 158–64. http://dx.doi.org/10.1007/s11934-008-0028-x.

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36

Ludwig, Michael, Bonnie Ching, Heiko Reutter, and Simeon A. Boyadjiev. "Bladder exstrophy-epispadias complex." Birth Defects Research Part A: Clinical and Molecular Teratology 85, no. 6 (June 2009): 509–22. http://dx.doi.org/10.1002/bdra.20557.

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37

Saltzman, Brian, David T. Mininberg, and Edward C. Muecke. "Epispadias: Contending with continence." Urology 26, no. 3 (September 1985): 256–64. http://dx.doi.org/10.1016/0090-4295(85)90122-0.

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38

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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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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Baird, A. D., J. P. Gearhart, and R. I. Mathews. "Applications of the modified Cantwell–Ransley epispadias repair in the exstrophy–epispadias complex." Journal of Pediatric Urology 1, no. 5 (October 2005): 331–36. http://dx.doi.org/10.1016/j.jpurol.2005.02.003.

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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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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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Bianchi, A., R. Angotti, G. Giannotti, F. Ferrara, E. Cerchia, G. Di Maggio, and M. Messina. "FEMALE EPISPADIAS: A CASE REPORT." Journal of the Siena Academy of Sciences 2, no. 1 (May 16, 2012): 49. http://dx.doi.org/10.4081/jsas.2010.49.

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Frimberger, Dominic. "Diagnosis and management of epispadias." Seminars in Pediatric Surgery 20, no. 2 (May 2011): 85–90. http://dx.doi.org/10.1053/j.sempedsurg.2011.01.003.

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Abhyankar, Aruna, Divyesh Desai, and Peter Cuckow. "The Kelly Operation for Epispadias." Journal of Pediatric Urology 4 (April 2008): S75—S76. http://dx.doi.org/10.1016/j.jpurol.2008.01.139.

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Tantibhedhyangkul, Julierut, Susannah D. Copland, Andrea M. Haqq, and Thomas M. Price. "A case of female epispadias." Fertility and Sterility 90, no. 5 (November 2008): 2017.e1–2017.e3. http://dx.doi.org/10.1016/j.fertnstert.2007.12.055.

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Faraj, S., I. Talon, D. Demede, P. Mouriquand, and M. D. Leclair. "Cirugía del complejo extrofia-epispadias." EMC - Urología 55, no. 4 (December 2023): 1–21. http://dx.doi.org/10.1016/s1761-3310(23)48493-9.

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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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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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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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