Epispadias: Symptoms, Treatments, and Patient Care

The male urethra runs through the penis inside the corpus spongiosum and empties into the urethral meatus in the apical area of ​​the glans after passing through it. If due to a malformation in the development of the urethra, it does not lead to the end of the glans but to the dorsal aspect of the penis (the anterior aspect of the penis as it is flaccid), it is said that the patient suffers from epispadias.

How is it produced?

Epispadias is very rare, it occurs in 1 in every 120,000 patients. It is due to a congenital malformation that in most cases is associated with bladder exstrophy (part of the bladder emerges through the skin) or other malformations of the bony pelvis, abdominal wall or external genitalia.

Epispadias can be classified based on the location of the outlet of the urethra:

• Glandular epispadias, in which the urethra opens on the dorsal aspect of the glans, which is usually wide and flattened.
• Penile epispadias, in which the urethral meatus opens along the dorsal aspect of the shaft of the penis. In general there is a flattened groove between the meatus and the glans.
• Penopubic epispadias, with the outlet of the urethra at the level of the junction of the penis with the pubis.

Symptoms

The main symptoms are those derived from urinary incontinence. In general, patients with glandular epispadias do not present it, but the rest do. It is usually due to abnormal development of the urinary sphincters. Having urinary incontinence can predispose you to recurrent urinary tract infections.

Diagnosis

The diagnosis is based on the examination of the patient. It should be assessed that there are no other malformations in the area.

Treatment

Treatment of epispadias is complex and surgical. Surgery, sometimes with multiple interventions, will require correction of incontinence, removing the cord to straighten the penis, and extending the urethra to the glans penis.

Precautionary measures

Since it is a congenital malformation, there are no preventive measures to avoid epispadias.