Long-Term Outcomes After Surgical Repair of Isolated Epispadias: A Single Center Experience

Elrefaei A1, Elkashef A1, Hafez A1

Research Type

Clinical

Abstract Category

Paediatrics

Abstract 547
Open Discussion ePosters
Scientific Open Discussion Session 105
Friday 19th September 2025
13:40 - 13:45 (ePoster Station 2)
Exhibition
Retrospective Study Pediatrics Incontinence
1. Department of Urology, Urology and Nephrology Center, Mansoura University, Egypt
Presenter
Links

Abstract

Hypothesis / aims of study
Isolated epispadias is a rare congenital urogenital anomaly. We, therefore, aimed to evaluate our long-term results after surgical repair of isolated epispadias during childhood.
Study design, materials and methods
In a retrospective study, we reviewed the data of patients with isolated epispadias who underwent surgical repair from January 2005 to December 2021. We reported the number of the patients, their gender, the age at initial surgery, follow-up period, type of epispadias, complications of surgical repair, the need for additional reconstructive surgeries, continent status of the patients, type of surgeries to achieve continence for incontinent patients, post-operative continent status, renal and bladder ultrasound (RBUS) and voiding cystourethrogram (VCUG) for those who underwent continence surgeries.
Results
A total number of 29 patients were included, 28 (96.5%) of them were males, while the remaining 1 (3.5%) was female. Their median age at initial surgery was 36 (6-156) months and median follow-up was 60 (36-192) months. Twenty-two patients (75.9%) had penopubic, 4 (13.7%) midshaft, 2 (6.9%) distal and 1 (3.5%) female epispadias. Three patients (10.3%) developed urethrocutaneous fistula, 2 (6.9%) had dehiscence of glans, 1 (3.5%) had recurrent epispadias and 1 (3.5%) had disfigured penis after surgical repair. Repair of fistula was performed in 3 patients (10.3%), phalloplasty in 3 patients (10.3%) and redo repair in 1 patient (3.5%). Twenty-four patients (82.7%) were continent and the remaining 5 patients (17.3%) were incontinent, for which bladder neck injection was done in 3 patients (10.3%), bulbourethral sling in 1 patient (3.5%) and bladder neck repair with bladder augmentation and continent cutaneous outlet in 1 patient (3.5%). All patients who had surgeries to achieve continence remained continent and showed no hydronephrosis by RBUS and no vesicoureteral reflux, normal bladder capacity, shape and outline by VCUG till the last follow-up.
Interpretation of results
Our study included 29 patients; the majority of them were males with penopubic epispadias. Surgical repair was successfully performed in most of these patients, however, complications such as urethrocutaneous fistula, dehiscence of glans, recurrent epispadias and disfigured penis occurred and were surgically corrected. Urinary continence was reported in 82.7% of patients with isolated epispadias. On the other hand, those who were urinary incontinent underwent continence surgeries, such as bladder neck injection, bulbourethral sling and bladder neck repair with bladder augmentation and continent cutaneous outlet. Patients who had continence surgeries achieved continence and showed no hydronephrosis or vesicoureteral reflux, normal bladder capacity, shape and outline during follow-up.
Concluding message
Isolated epispadias needs complex surgical repair and multiple procedures to achieve good cosmetic results and urinary continence. Moreover, long-term follow-up is required.
Disclosures
Funding I have no funding source or grant. Clinical Trial No Subjects Human Ethics Committee Mansoura Faculty of Medicine - Institutional Research Board (MFM-IRB) Helsinki Yes Informed Consent Yes
07/07/2025 14:30:35