Epispadias in a 32-Year-Old Patient with Congenital Malformatiom: Bladder-Epispadias Exstrophy at Birth

Abstract

Bladder atrophy and / or epispadias This is an orphan genetic malformation affecting one child in 30 to 40 thousand births. This malformation requires immediate surgical management in a specialized center. Many interventions will be essential in order to resolve urinary and genital problems. Treatment protocols vary, but are still based on three essential steps: closing the bladder in the neonatal period; reconstruction of the urethra and penis in boys; bladder emptying and continence surgery. If the first two stages are well mastered, the last remains a challenge, because the techniques in force are unable to restore the active and complex mechanisms that manage bladder emptying and the maintenance of dryness between two bladder emptying. We now have to resolve to create passive subbladder resistance associated with intermittent multi-daily catheterization in order to preserve the upper urinary tract, which remains the first priority.