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Epispadias repair using the Mitchell technique
K L Narasimhan1, S K Mohanty, N Singh
1Department of Paediatric Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Purpose:
The results of epispadias repair using Mitchell's technique in nine patients is analyzed and the advantages of the procedure discussed.
Methods:
Nine boys aged between 6 weeks and 6 years underwent epispadias repair between November 1996 and March 1998 (Penopubic epispadias, inferior vesical fissure, and midpenile epispadias, one patient each; exstrophy epispadias complex, six patients). Eight patients had first attempt at repair of epispadias. Two patients had closure of exstrophy and epispadias at one stage.
Results:
At a mean follow-up of 10 months, all children had a conical glans, eight patients had ventral orthotopic meatus, and one had coronal hypospadiac meatus. Minor penopubic fistula developed in one patient. Six patients had downward angled penis, and three had horizontal penis in a flaccid state. All children were observed to have good erections during sleep.
Conclusions:
Mitchell's technique of epispadias repair allows an anatomic reconstruction of the penis with superior cosmetic and functional results. Long-term follow-up studies are necessary to evaluate the genital functions.