Epispadias
What causes this problem and how common is it:
It’s a developmental anomaly. It is not a genetic defect and could not have been preventable by taking extra care or avoiding something. It is not possible to pick up on ANC sonogram, (unless associated with Extropy bladder). It is not a condition passed on from the father or mothers side.
What are the Symptoms:
depending on the severity of the condition
- Distal – cosmetic
- Passing urine on abdomen
- Future sexual disfunction
- Proximal
- inability to control a urinary leak
- cosmetic
- Passing urine on abdomen
- Future sexual disfunction
- In association with Exstrophy Bladder
When to see your doctor:
The attending Pediatrician will have seen it at birth and a family counselling with a Pediatric Surgeon should be scheduled when all caretakers can be attending.
How is it diagnosed: It’s a visual diagnosis
What are the treatments available: SURGICAL RECONSTRUCTION is the ONLY and proper way of treatment.
Are there any alternatives to surgery: NO
What does the operation involve:
The operation involves the correction of the various subsegments of this condition. Viz
- Bring the urinary opening to the tip of the penis
- Bring the urinary tube on the undersurface of the penis
- Correct the upward bend of the penis (correct dorsal chordee)
- Try and lengthen the shaft of the penis
To achieve this, surgery will involve
- General and Regional anesthesia
- Surgery for 1 – 3 hrs duration
- Catheter in the postop condition for 7-10 days
- Antibiotics and pain killers
- Some form of restraint to prevent accidental removal of the catheter
- Stay in the hospital for 3-10 days
What are the possible complications / what happens after the operation:
- A child will have a catheter for 7 – 10 days
- The child will be prescribed antibiotics and painkillers
- Constipation should be avoided
- There is a small risk of surgery if needed.
What is the outlook or future of these children:
- These children should have normal urinary and sexual functions.
- Cosmetic appearance can be excellent if expectations are pragmatic.
- In conditions with severe deformity, where incontinence is also present, partial continence or assisted voiding may be needed to stay dry.
