Learn About Epispadias
Epispadias is a rare defect that is present at birth. In this condition, the urethra does not develop into a full tube. The urethra is the tube that carries urine out of the body from the bladder. The urine exits the body from the wrong place with epispadias.
Congenital defect - epispadias
The causes of epispadias are not known. It may occur because the pubic bone does not develop properly.
Epispadias can occur with a rare birth defect called bladder exstrophy. In this birth defect, the bladder is open through the wall of the abdomen. Epispadias can also occur with other birth defects.
The condition occurs more often in boys than girls. It is most often diagnosed at birth or soon afterward.
Males will have a short, wide penis with an abnormal curve. The urethra most often opens on the top or side of the penis instead of the tip. However, the urethra may be open along the whole length of the penis.
Females have an abnormal clitoris and labia. The urethral opening is often between the clitoris and the labia, but it may be in the belly area. They may have trouble controlling urination (urinary incontinence).
People who have more than a mild case of epispadias will need surgery.
Leakage of urine (incontinence) can often be repaired at the same time. However, a second surgery may be needed either soon after the first surgery, or sometime in the future.
Johns Hopkins University
Dr. John P. Gearhart is a professor of pediatrics and urology at the Johns Hopkins School of Medicine. His clinical and surgical interests focus on the evaluation and treatment of children born with major congenital birth defects, bladder exstrophy, disorders of sexual development and childhood urinary cancers. Dr. Gearhart received his M.D. from the University of Louisville School of Medicine in 1975. After an internship in surgery and residencies in surgery and urology at the Medical College of Georgia, he completed a fellowship in pediatric urology at Alder Hey Children's Hospital of the University of Liverpool School of Medicine in 1981. Following two years as a urologist at St. Mary's Hospital in Huntington, West Virginia, he completed a second fellowship in pediatric urology at Johns Hopkins in 1985 and joined the Johns Hopkins faculty thereafter as an associate professor of pediatric urology. Over the course of his distinguished career, Dr. Gearhart has been lauded as a pioneer in pediatric urology and reconstructive genitourinary surgery. He has published extensively and has received numerous awards and guest lectureships. He is a member of several national and international professional organizations and is a founding member of the Society of Reconstructive Genitourinary Surgeons. Dr. Gearhart is rated as an Elite provider by MediFind in the treatment of Epispadias. His top areas of expertise are Cloacal Exstrophy, Exstrophy of the Bladder, Exstrophy-Epispadias Complex, Osteotomy, and Bladder Reconstruction.
Miroslav Djordjevic is an Urologist in New York, New York. Dr. Djordjevic is rated as an Elite provider by MediFind in the treatment of Epispadias. His top areas of expertise are Epispadias, Hypospadias, Meatal Stenosis, Reconstructive Urology Surgery, and Vaginectomy.
Marta Bizic practices in Belgrade, Serbia. Ms. Bizic is rated as an Elite expert by MediFind in the treatment of Epispadias. Her top areas of expertise are Epispadias, Hypospadias, Meatal Stenosis, Reconstructive Urology Surgery, and Vaginectomy.
Surgery can help the person control the flow of urine. It will also fix the appearance of the genitals.
Some people with this condition may continue to have urinary incontinence, even after surgery.
Ureter and kidney damage and infertility may occur.
Contact your health care provider if you have any questions about the appearance or function of your child's genitals or urinary tract.
Summary: The purpose of this study is to evaluate the effectiveness and safety of a minimally invasive surgical procedure with ACT (Adjustable Continence Therapy) balloons implantation for the treatment of urinary incontinence in children with bladder exstrophy or isolated epispadias. The ACT therapy consists of two small adjustable silicone balloons connected with a tubing to a port, surgically placed aro...
Published Date: October 15, 2023
Published By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Chaudhry R, Cannon GM. Urologic disorders. In: Zitelli BJ, McIntire SC, Nowalk AJ, Garrison J, eds. Zitelli and Davis' Atlas of Pediatric Physical Diagnosis. 7th ed. Philadelphia, PA: Elsevier; 2023:chap 15.
Elder JS. Anomalies of the bladder. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 556.
Gearhart JP, Di Carlo HN. Exstrophy-epispadias complex. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 31.