FEMALE EPISPADIAS REPAIR: A NEW 1-STAGE TECHNIQUE

Abstract

No AccessJournal of UrologyPEDIATRIC UROLOGY1 Aug 2000FEMALE EPISPADIAS REPAIR: A NEW 1-STAGE TECHNIQUE TOM P.V.M. DE JONG, PIETER DIK, and AART J. KLIJN TOM P.V.M. DE JONGTOM P.V.M. DE JONG More articles by this author , PIETER DIKPIETER DIK More articles by this author , and AART J. KLIJNAART J. KLIJN More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)67409-5AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Female epispadias is a rare anomaly. According to the literature it is usually treated with staged procedures, including bladder neck reconstruction, to achieve continence. We developed a 1-stage surgical technique that offers the possibility of achieving continence and a cosmetically normal appearance of the vulva. Materials and Methods: We treated 4 patients 4 months to 8 years old. The main point of the technique is to free completely the urethral plate and bladder neck from surrounding tissue. After tubularizing the urethral plate into a urethra modified needle suspension brings the bladder neck and proximal urethra into the intra-abdominal position. The pelvic floor is then reconstructed between the anterior vaginal wall and urethra. Thus, continence may be attained by intra-abdominal positioning of the bladder neck and proximal urethra as well as by pelvic floor reconstruction. Results: Of our 4 consecutive cases of primary untreated epispadias the technique proved successful in 3, while followup is too short in 1. One patient is completely dry and voids without a further procedure. Postoperatively 2 patients with 5 years or more of followup required injection of a bulking agent at the bladder neck level to achieve continence, including 1 who is damp during the day without the need to change clothes and 1 on clean intermittent catheterization twice daily because post-void residual urine volume causes recurrent urinary tract infection. Conclusions: The described technique is promising for treating this disabling anomaly. References 1 : Congenital epispadias with incontinence. J Urol1949; 62: 513. Link, Google Scholar 2 : Bladder prolapse in a female infant with complete epispadias. J Urol1997; 157: 1438. Link, Google Scholar 3 : Epispadias. In: . Chicago: Year Book Medical Publishers1979: 1377. chapt. 123. Google Scholar 4 : Surgical correction of female epispadias. Eur Urol1982; 8: 321. Google Scholar 5 : Congenital female epispadias with incontinence. J Urol1981; 125: 558. Link, Google Scholar 6 : Complete genitourinary reconstruction in female epispadias. J Urol1993; 149: 1110. Link, Google Scholar 7 : Female epispadias. J Urol1997; 158: 1543. Link, Google Scholar From the Pediatric Renal Center, University Medical Center Utrecht, Children’s Hospital, Utrecht, The Netherlands© 2000 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited ByCheikhelard A, Aigrain Y, Lottmann H and Lortat-Jacob S (2009) Female Epispadias Management: Perineal Urethrocervicoplasty Versus Classical Young-Dees ProcedureJournal of Urology, VOL. 182, NO. 4S, (1807-1812), Online publication date: 1-Oct-2009. Volume 164Issue 2August 2000Page: 492-494 Advertisement Copyright & Permissions© 2000 by American Urological Association, Inc.KeywordsvulvaurethraabnormalitiesepispadiasMetricsAuthor Information TOM P.V.M. DE JONG More articles by this author PIETER DIK More articles by this author AART J. KLIJN More articles by this author Expand All Advertisement PDF DownloadLoading ...