Male epispadias

ABSTRACT

A better anatomical and embryological knowledge has allowed a significant advance in the management of male epispadias. Surgery has the following goals 1. reconstruction of the urethra to enable urine voiding, either spontaneously or by intermittent catheterization through a neomeatus placed at the distal portion of the glans; 2. attainment of urinary continence preserving the upper urinary tract; 3. reconstruction of the penis so that its morphological characteristics be adequate to enable sexual relations; 4. achievement of a favorable esthetical appearance. Modern techniques provide good results with a low rate of complications. At present, the best technique for male epispadias repair is the modification introduced by ransley in the technique originally described by Cantwell. Although Mitchell's technique is promising more experience is to be gained through a close follow-up of patients