Contact Us  |  Search: 
Printer Friendly VersionEmail A FriendAdd ThisIncrease Text SizeDecrease Text Size

Epispadias

 

Definition

Epispadias is a rare congenital (present from birth) defect located at the opening of the urethra.

In this condition, the urethra does not develop into a full tube and the urine exits the body from an abnormal location.

Causes

The causes of epispadias are unknown at this time. Itmay be related to improper development of the pubic bone.

In boys with epispadias, the urethra generally opens on the top or side of the penis rather than the tip. However, it is possible for the urethra to be open along the entire length of the penis.

In girls, the opening is usually between the clitoris and the labia, but may be in the belly area.

Epispadias can be associated with bladder exstrophy, an uncommon birth defect in which the bladder is inside out, and sticks through the abdominal wall. However, epispadias can also occur with other defects.

Epispadias occurs in 1 in 117,000 newborn boys and 1 in 484,000 newborn girls. The condition is usually diagnosed at birth or shortly thereafter.

Symptoms

In males:

  • Abnormal opening from the joint between the pubic bones to the area above the tip of the penis
  • Backward flow of urine into the kidney (reflux nephropathy)
  • Short, widened penis with an abnormal curvature
  • Urinary tract infections
  • Widened pubic bone

In females:

  • Abnormal clitoris and labia
  • Abnormal opening where the from the bladder neck to the area above the normal urethral opening
  • Backward flow of urine into the kidney (reflux nephropathy)
  • Widened pubic bone
  • Urinary incontinence
  • Urinary tract infections
Signs and tests
  • Blood test to check electrolyte levels
  • Intravenous pyelogram (IVP), a special x-ray of the kidneys, bladder, and ureters
  • MRI and CT scans, depending on the condition
  • Pelvic x-ray
  • Ultrasound of the urogenital system
Support Groups

Expectations (prognosis)

Surgery generally leads to the ability to control the flow of urine and a good cosmetic outcome.

Calling your health care provider

Call your health care provider if you have any questions or concerns regarding your child's genitourinary tract appearance or function.

Complications

Persistent urinary incontinence can occur in some persons with this condition even after several operations.

Upper urinary tract (ureter and kidney) damage and infertility may occur.

Treatments

Surgical repair of epispadias is recommended in patients with more than a mild case. Leakage of urine (incontinence) is not uncommon and may require a second operation.

Prevention

References

Gearhart JP, Mathews R. Exstrophy-epispadias complex. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 119.

Elder JS. Anomalies of the bladder. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 541.


Review Date: 1/21/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2009 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
MAIMONIDES
MEDICAL CENTER


Home Page
Why Choose Us
Donations
Website Terms of Use
PATIENT
INFORMATION


Visitor & Patient Info
We Speak Your Language
Patient Privacy
Contact Us
KEY
INFORMATION


Find a Physician
Medical Services
Maimonides In the News
Directions & Parking
FOR HEALTH
PROFESSIONALS


Medical Education
Career Opportunities
Nurses & Physicians
Staff Intranet Access

Maimonides Medical Center    |    4802 Tenth Avenue    |    Brooklyn, NY 11219    |    718.283.6000