Partial penile disassembly for isolated epispadias repair

Area of Science:

• Urology
• Pediatric Surgery
• Reconstructive Surgery

Background:

• Isolated male epispadias occurs in 10% of epispadias-exstrophy complex cases.
• Surgical repair techniques for epispadias malformations are varied and debated.
• The partial penile disassembly technique is presented for isolated epispadias repair.

Purpose of the Study:

• To present the surgical experience with partial penile disassembly for isolated epispadias repair.
• To evaluate the efficacy and outcomes of this technique in pediatric patients.

Main Methods:

• Eleven male patients (ages 4-13) with isolated epispadias (penopubic, penile, glanular) underwent repair.
• The technique involved extensive penile component disassembly to corporal attachments.
• Urethral plate tubularization and ventral transposition via corporal rotation were performed, followed by glanuloplasty.

Main Results:

• Satisfactory cosmetic appearance and no significant dorsal chordee were observed post-surgery.
• Two cases resulted in subcoronal hypospadias due to urethral plate shortening.
• One patient developed a minor penopubic fistula, successfully repaired later.

Conclusions:

• The partial penile disassembly technique effectively restores the anatomical relationships of penile components.
• This technique is a straightforward modification of the Mitchell technique for isolated epispadias repair.