Epispadias is an extremely rare malformation that urethral opening is located on the dorsum of the penis. The severity of the epispadiac defect depends upon the degree of persistence of the cloacal membrane. Treatment goals of epispadiac patients include restoration of normal urinary control and establishment of a straight penis of adequate length that is functional for normal sexual intercourse. Recently we have experienced a case of glandular epispadias and report it with brief review of literature.
Coitus ; Epispadias* ; Humans ; Male ; Membranes ; Penis

A case of female epispadias, which was observed in a 22-year old female having suffered from urinary incontinence since birth, is presented. Urethral construction resulted in complete urinary continence. The literature is reviewed briefly.
Epispadias* ; Female* ; Humans ; Parturition ; Urinary Incontinence ; Young Adult

Female epispadias is an uncommon congenital anomaly in genitourinary tract. We experienced a case of female epispadias with total urinary incontinence which was improved with periurethral injection of Glutaraldehyde Cross-Linked Collagen(GAX-Collagen) into the area of the bladder neck. The procedure was simple to perform and without significant complications. Herein we report a case of female epispadias in 29-year old female.
Adult ; Epispadias* ; Female* ; Glutaral ; Humans ; Neck ; Urinary Bladder ; Urinary Incontinence

Epispadias is an extremely rare malformation that urethral opening is located on the dorsum of the penis. Depending upon its location epispadias is classified as balanic, penile, or penopubic, the latter being by far the most common condition. Most patients of epispadias will have severe urinary incontinence and vesicoureteral reflux. The objects of management in epispadias are to achieve continence, to facilitate normal sexual activity, and to preserve renal function. Recently we have experienced two cases of epispadias without incontinence.
Epispadias* ; Humans ; Male ; Penis ; Sexual Behavior ; Urinary Incontinence ; Vesico-Ureteral Reflux

Penile epispadias is extremely rare congenital anomaly. Four cases of epispadias. two of which were penile. one was penopubic and one was subsymphyseal epispadias, had been reported previously in our department. We have experienced another case of penile epispadias. Herein this case of penile epispadias have been presented. A 7-year-old boy visited this clinic for short, broad based 'tent-like' penis with complete phimosis. The glans could not be inspected due to phimosis and a gutter was palpated between the two corpora. Voiding cystourethrogram revealed dorsally displaced urethra. There was no combined urological symptoms such as dysuria, frequency in urination or urinary incontinence. Urethral reconstruction by Young's method has been performed with excellent result.
Child ; Dysuria ; Epispadias* ; Female ; Humans ; Male ; Penis ; Phimosis ; Urethra ; Urinary Incontinence ; Urination

OBJECTIVETo evaluate a modified Mitchell's technique for epispadias repair.

METHODSThree patients with epispadias were undergoing the treatment. It was performed to form a penile pedicled flap or scrotal mediastinum flap for the repair of the urethra and the urine was drained through a perined "U" shaped stent.

RESULTSAll of the patients were successfully treated in one-stage with a good appearance and a matching opening of the urethra.

CONCLUSIONThe above mentioned technique could be a good method for epispadias repair.

Drainage ; Epispadias ; surgery ; Humans ; Male ; Penis ; surgery ; Stents ; Surgical Flaps ; Urethra ; surgery ; Urologic Surgical Procedures, Male ; methods

Reconstruction of the male urethra is required for a multitude of congenital anomalies, such as hypospadias and epispadias, as well as fort acquired lesions such as stricture disease and trauma. No method is appropriate for all types of repair of the urethra. A successful surgical reconstruction of the urethra is the result of a proper operative selection that depends on the site and length of the disrupted urethra and also depends on, as well as the experience of the surgeon. Reconstruction of the urethra has been performed by the use of homografts, silicone tubes, grafts taken from the bladder mucosa. But serious postoperative problems, such as urinary fistula, urethrostenosis, stricture of the site of urethral anastomosis, and diverticulum formation, are not uncommon. Especially, reconstruction of Proximal urethra is very difficult because of limitations of operation field exposure and flap transfer. However, the hairless median scrotal skin flap with the scrotal septum attached, rich in neurovascular plexus, is ideal material for creating a new urethra without interference to its blood supply and other complications. We experienced a successful reconstruction of the proximal urethral defect in about 8cm length and perineal sore with pedicled scrotal septal flap and gracilis musculocutaneous flap, respectively.
Allografts ; Constriction, Pathologic ; Diverticulum ; Epispadias ; Female ; Humans ; Hypospadias ; Male ; Mucous Membrane ; Myocutaneous Flap ; Silicones ; Skin ; Transplants ; Urethra ; Urinary Bladder ; Urinary Fistula

The increased occurrence of genitourinary tract anomalies in infants with imperforate anus is well documented. A retrospective analysis was made on 130 children with imperforate anus over the last 10 years. A 21%(27cases) incidence of associated genitourinary anomalies was found in this series. Patients with high and intermediate imperforate anus demonstrated a 30%(19/61) incidence of genitourinary anomalies. In contrast, patients with low imperforate anus revealed 12% (8/66) incidence of genitourinary anomalies. The spectrum of these anomalies were hydronephrosis. bilateral renal agenesis, bilateral polycystic kidney, bilateral VUR, unilateral renal hypoplasia, posterior urethral stricture, renal stone, cryptorchidism, hypospadias and epispadias in descending frequency of order. Hydronephrosis( 13/27, 48%) was the most frequently encountered anomaly. Patients with high imperforate anus seems to be prone to have more severe urinary anomalies. Fistulae between the rectum and urinary tract were found in 33 patients with high and intermediate type imperforate anus( rectourethral fistula; 27 cases, rectovesical fistula, 3 cases, rectocloacal fistula, 3 cases). During the posterior sagittal anorectoplasty, fistula was corrected simultaneously. In conclusion, early urological screening should be done for the early diagnosis and treatment of associated genitourinary anomalies in all children with imperforate anus.
Anus, Imperforate* ; Child ; Cryptorchidism ; Early Diagnosis ; Epispadias ; Female ; Fistula ; Humans ; Hydronephrosis ; Hypospadias ; Incidence ; Infant ; Male ; Mass Screening ; Polycystic Kidney Diseases ; Rectum ; Retrospective Studies ; Urethral Stricture ; Urinary Tract

OBJECTIVETo investigate the effect of in utero exposure to di-n-butyl phthalate (DBP) on the protein expression in the penile tissue of hypospadiac rats, isolate and identify differentially expressed proteins, and determine the role of the differential expression of Annexin A3 in the development of hypospadia in the rat offspring after maternal exposure to DBP.

METHODSTwenty pregnant SD rats were randomly assigned to an experimental group, intragastrically administered DBP at 800 mg/kg, and a control group, given soybean oil at 5 ml/kg, both for 5 days. Three days after birth, the penises of the newborn rats were removed, and the total protein extracted for 2D-electrophoretic separation and image analysis. Differentially expressed protein spots were screened and identified by mass spectrometry, and the changes in the expression of Annexin A3 detected by Western blotting and immunohistochemistry.

RESULTSThirty-one differentially expressed protein spots were screened, of which 17 were identified by mass spectrometry and the SwissProt database, including pyruvate kinase M2, alpha-enolase, and Annexin A3. Western blot showed that Annexin A3 was mainly located in the urethral epithelia and had a lower expression in the hypospadiac rats (1.851 +/- 0.014, n = 10) than in the controls (2.603 +/- 0.012, n = 10) (P < 0.05).

CONCLUSIONA pedigree of differentially expressed proteins in the penises of DBP-induced hypospadia and normal rats was established by the proteomic method. The differential expression of Annexin A3 may play an important role in the development of hypospadia.

Animals ; Animals, Newborn ; Annexin A3 ; metabolism ; Dibutyl Phthalate ; adverse effects ; Epispadias ; Female ; Hypospadias ; metabolism ; Male ; Maternal Exposure ; Penis ; metabolism ; Pregnancy ; Proteome ; analysis ; Proteomics ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo investigate the pathological characters and anatomic correction of penile epispadias.

METHODSThe urethra was formed by local urethra plate mucosa flaps. The contracture on dorsum of penis was released by cutting off the superficial suspensory ligament to reposition the penile and urethral sponge.

RESULTSFrom Jun. 2004 to Dec. 2010, 26 cases with penile epispadias were treated. 18 cases were followed up for 6 months to 5 years. 10 cases were treated successfully with good cosmetic and functional results. Urinary incontinence happened in 8 cases, which healed after tightening operation.

CONCLUSIONSThe anatomic correction of penile epispadias can recover the normal anatomic structure, resulting good cosmetic and functional results.

Adolescent ; Adult ; Child ; Child, Preschool ; Epispadias ; surgery ; Humans ; Male ; Penis ; anatomy & histology ; surgery ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; Surgical Flaps ; Urethra ; anatomy & histology ; surgery ; Urologic Surgical Procedures, Male ; methods ; Young Adult