Title: Complete Penile Disassembly for Epispadias Repair in Isolated Epispadias in a Postpubertal Patient: A Case Report
Authors: Dr (Prof) A.K.Roy, Dr Rahul Bhushan, Dr Anurag Saraswat, Dr Saurabh Rai
DOI: http://dx.doi.org/10.18535/jmscr/v3i11.05
Epispadias is a rare congenital malformation of the male or female urogenital apparatus that consists of a defect of the dorsal wall of the urethra. The extent of the defect can vary from a mild glandular defect to complete defects as are observed in bladder exstrophy, diastasis of the pubic bones, or both (see second image below). Simple epispadias occurs less commonly than the more severe form associated with exstrophy of the bladder. Complete disassembly allows tubularization and ventralization of the entire distal urethra; makes glans and urethral repair independent; separates the 2 corporeal glandular bodies, permitting easier and more complete release of the rotation contributing to dorsal chordee, and improves exposure for corporotomy or dermal grafts. CPD is a safe and highly successful technique for epispadias repair in infants, boys and adults. There is an ongoing concern with the procedure in neonates. The procedure has a satisfactory outcome when performed for isolated epispadias. 1. Kureel SN, Gupta A, Singh CS, Kumar M. Surgical anatomy of penis in exstrophy-epispadias: a study of arrangement of fascial planes and superficial vessels of surgical significance. Urology. 2013 Oct. 82(4):910-6. [Medline]. 2. Ben-Chaim J, Peppas DS, Jeffs RD, Gearhart JP. Complete male epispadias: genital reconstruction and achieving continence. J Urol. 1995 May. 153(5):1665-7. [Medline]. 3. Mollard P, Basset T, Mure PY. Male epispadias: experience with 45 cases. J Urol. 1998 Jul. 160(1):55-9.[Medline]. 4. Surer I, Baker LA, Jeffs RD, Gearhart JP. The modified Cantwell-Ransley repair for exstrophy and epispadias: 10- year experience. J Urol. 2000 Sep. 164(3 Pt 2):1040-2; discussion 1042-3. [Medline]. 5. Mokhless I, Youssif M, Ismail HR, Higazy H. Partial penile disassembly for isolated epispadias repair.Urology. 2008 Feb. 71(2):235-8. [Medline]. 6. Curr Opin Urol. 2012 Nov;22(6):457-61. doi: 10.1097/MOU.0b013e3283589793. Epispadias repair: functional outcome of complete disassembly.Hafez AT1.Abstract
References