A Rare Case of Isolated Male Epispadias

Shehzad, Dawood; Shehzad, Mustafa; Mutaal, Abdul

doi:10.7759/cureus.46160

Cited by 1 publication

(15 citation statements)

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“…Generally the phallus is broad and short with a dorsal chordee, an open urethral plate and absent dorsal foreskin in the male child, while in the female child, it presents as a bifid clitoris and labia minora. This is contrary to the case in hypospadias, where the meatus lies ventrally on the penile shaft [1,4,7].…”

Section: Introductionmentioning

confidence: 61%

“…Isolated male epispadias is characterized by the position of the urethral opening, from peno-pubic to penile and glandular [1,2]. It is due to failure of the urethral plate to tubularize on the dorsum of the penis during embryonic development thereby giving rise to a dorsally located ectopic urethral meatus [1,4]. Epispadias is rare with an incidence rate of 1 in 117,000 live births in males and 1 in 1,300,000 live births in females [1,2,5,6].…”

Section: Introductionmentioning

confidence: 99%

“…Epispadias is rare with an incidence rate of 1 in 117,000 live births in males and 1 in 1,300,000 live births in females [1,2,5,6]. Epispadias is associated with many co-exisiting congenital conditions such as vesicoureteric reflux (VUR), bladder exstrophy, urinary incontinence and inguinal hernia [4,7]. The incidence of co-existing VUR is 30 -75% and of inguinal hernia is 35% [7].…”

Section: Introductionmentioning

confidence: 99%

“…The vast majority of epispadias that occur in association with bladder exstrophy are classified as non-syndromic. The etiology of this malformation remains unknown, [1] however, it has been proposed that an abnormal overdevelopment of the cloacal membrane preventing medial migration of mesenchyme between the ectodermal and endodermal layers may be the basis for this anomaly [1,4,8].…”

Section: Introductionmentioning

confidence: 99%

“…A micturating cystourethrogram is useful in evaluating the bladder capacity as well as the presence of vesicoureteric reflux [7]. Managing epispadias poses a great challenge and its treatment is mainly surgical, involving bladder closure, urethral reconstruction and osteotomies if pubic diastasis is present [4,7]. In adults who present late the challenges include long-standing changes to the exposed urethral mucosa and the surrounding tissues.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Isolated Male Epispadias with Continence in a 40 Year Old: A Case Report

Atim T.,

Akpamgbo C. N.,

Eniola S. B.

et al. 2023

IJMPCR

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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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Section: Introductionmentioning

confidence: 61%