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.

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.

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.

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.

Isolated epispadias needs complex surgical repair and multiple procedures to achieve good cosmetic results and urinary continence. Moreover, long-term follow-up is required.