What is Epispadias?

Epispadias may either be associated with exstrophy or cloacal exstrophy; it can also exist as an apparent solitary abnormality of the penis. The urethra opens on the back of the penis, and the head of the penis is often split. Characteristic appearances of epispadias are also associated, in severe cases, with an abnormality of the bladder outlet, to the extent that continence may be a problem, particularly in girls, and in the majority of boys.

Epispadias is treated by repairing the penis and creating a urethra at the tip. This may usually be performed in a single stage operation. It is necessary, before this procedure, to assess the bladder outlet and gain some idea of the continence and potential for normal bladder function. If there are clearly issues at the level of the bladder neck, surgery may need to be performed on this also, to improve the continence outcome.