Long-term outcomes in primary male epispadias

Area of Science:

• Urology
• Pediatric Surgery
• Genitourinary Reconstruction

Background:

• Epispadias is a rare congenital condition affecting the genitourinary tract.
• Long-term outcomes for male epispadias patients are not well-documented, particularly regarding adult function.

Purpose of the Study:

• To evaluate the long-term outcomes of genitourinary reconstruction in male patients with primary epispadias.
• To assess the need for subsequent surgeries, continence, cosmetic satisfaction, and sexual function in adulthood.

Main Methods:

• Retrospective review of 30 male patients with primary epispadias.
• Analysis of data from transition into Adolescent and Adult Urology services.
• Median follow-up of 18.5 years.

Main Results:

• Twenty-eight patients (93%) required further surgery, with 26 for continence and 12 for revisions.
• At follow-up, 15 patients were continent, 9 had stress leakage, and 6 used a Mitrofanoff diversion.
• 17 of 19 patients expressed concerns about cosmetic outcomes; 20 of 21 reported normal erections, but 6 had chordee and 9 retrograde ejaculation.

Conclusions:

• The majority of male epispadias patients require multiple surgical interventions for continence.
• Significant long-term concerns exist regarding cosmetic appearance and sexual function despite corrective surgeries.
• Findings offer valuable insights for counseling patients and parents on expected adult outcomes.