Penopubic epispadias repair in adulthood: Surgical and functional outcome with modified Cantwell-Ransley procedure

Abstract

Isolated primary penopubic epispadias is a rare anomaly with a reported incidence of one in 11,700 males. It is unusual for patients with this anomaly to present for the first time in adulthood due to the fact that the clinical presentation is striking at birth. The hallmark of surgical repair is the reconstruction of a functionally and cosmetically appealing genitalia as well as proper citing of the neomeatus. Several surgical procedures for complete epispadias have been described in the literature, but the modified Cantwell-Ransley technique and the Mitchell-Bagli repair (complete penile disassembly) are the most widely used. We report a case of a 25-year-old man who presented to our facility for the first time for surgical treatment. The patient underwent the modified Cantwell-Ransley procedure based on surgeon's preference and expertise. The delay in presentation was a thing of concern to us as it is well-known that boys born with epispadias suffer poor self-image as they grow older and become aware of their genitalia. Following a successful modified Cantwell-Ransley procedure our patient's self-esteem, confidence, and sexual appeal greatly improved. We, therefore, conclude that surgical procedures such as the Cantwell-Ransley repair are appropriate even in cases presenting late in adulthood.