[Severe epispadias: the Mitchell's technique]

Epispadias associated or not to bladder extrophy is a congenital malformation with a difficult surgical correction. Mitchell published his technique in 1996, and it's based in the complete dissection of the uretheral band, ventral peneal skin and both corporas including their proximal insertion, that in next steps will be separated in all the length. These manoeuvres permit to: 1) Correct the dorsal incurvation; 2) Locate the urethra in a ventral position; 3) Locate the meatus at the tip of the penis with a vertical orientation.

We have performed these surgical procedure in 6 patients, 4 of them were epispadias (a 23 years old patient who had there surgical procedure, with persistent incurvation), the others two were associated with bladder extrophy, 3 had hormonal treatment previous surgery, due to a hypoplastic penis. In the two patients with bladder extrophy we used a labial mucosa graft sutured to the tubularized urethral plate to relocate the meatus at the tip of the penis.

The esthetic results were good in all cases, 2 had a fistula that was corrected surgically.