Results of Epispadias Repair Using the Modified Cantwell-Ransley Technique
Yuval Bar-Yosef1, Mario Sofer1, Margaret P Ekstein2
1Pediatric Urology, Dana-Dwek Children's Hospital, Tel-Aviv Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Objective:
To evaluate our results of epispadias repair with a modified Cantwell-Ransley (MCR) technique.
Methods:
A retrospective Institutional Review Board-approved chart review of all patients who underwent an MCR epispadias repair was conducted between 1998 and 2015. Procedures were performed at birth or after the age of 8 months as part of the modern staged repair of exstrophy-epispadias complex (EEC) in patients with bladder exstrophy treated since birth, at presentation for older patients, and after the age of 6 months in isolated epispadias patients. Twenty-two children underwent MCR epispadias repair in our institute during the study period. Sixteen of them had EEC and 6 had isolated epispadias. Four patients underwent exstrophy and epispadias repair at the same session. Twelve children underwent epispadias repair as a second stage of modern staged repair at a mean age of 21 months (range 8-60). The procedures involved dissection of the corporeal bodies and urethral plate from the penile base to the tip of the penile glans.
Results:
After a mean follow-up of 6.9 years (range 0.5-18), there were no complications in the isolated epispadias group and 4 complications in the bladder exstrophy group: urethrocutaneous fistula (n = 1), residual dorsal curvature (n = 1), and excess of penile skin (n = 2). The meatal location was orthotopic in all cases. All of the complications were successfully addressed in a single subsequent surgical session.
Conclusion:
MCR technique continues to be a reliable, reproducible option for epispadias repair in EEC patients and in cases of isolated epispadias.
