Most boys & girls were born with fully functional genitalia. But in congenital condition called epispadias may produce a vagina or penis that will not only performs unproductively, but it also looks like it was abnormal. Luckily, pediatric urologists have different surgical techniques at the disposal to repair the hooded foreskin, ill-placed urethral opening & curvature which was related with this condition.
PROCEDURE:
SURGICAL TECHNIQUE IN MALES:
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The first objective is customized Cantwell technique; this procedure may involve partial disassembly of the penis and then placement of the urethra in a original position.
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The second technique is the most recent development of the modern epispadias repair is the total disassembly of the penis into its divide the components – 2 corpora cavernosa and a 1 corpus spongiosum. Followed by disassembly of the 3 components are reassembled such that the urethra is in normal position and most functional and the dorsal chordee is rectified. Both the above techniques will provide a straight urethra located on the underside of the penis, correction of chordee and an acceptable cosmetic result. The disassembly method has a lower difficulty rate and facilitates both bladder and bladder neck repair. Occasionally, boys with the exstrophy-epispadias complex will be born with a tiny or severely underdeveloped or undersized penis. In these cases, surgical rebuilding of the penis is much more difficult, and sometimes reserved for whole phalloplasty.
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Sometimes, boys with the exstrophy-epispadias complex will born with a small or severely underdeveloped penis. In this type of situations, surgical treatment for reconstruction of the penis was more difficult.
SURGICAL TECHNIQUE IN FEMALES:
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Genital reconstruction in the girls with bladder exstrophy was less complex when compared with the reconstruction in the boys.
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The urethra & vagina will be short & near the front of the body & the clitoris is in 2 parts. The internal female structures – ovaries, uterus and fallopian tubes – were normal.
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If it was diagnosed at the time of birth, the 2 parts of the clitoris will be brought together & the urethra may be placed into the original position. If it was repaired in early enough, lack of the urinary control wil not be the problem.
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If the diagnosis was missed or if early repair was not done, then incontinence may be surgically corrected at the time of the diagnosis. If the vaginal opening was narrow in the younger women or older girls, reconstruction may be performed after the puberty.
