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Complete genitourinary reconstruction in female epispadias
J P Gearhart1, D S Peppas, R D Jeffs
1Department of Urology, James Buchanan Brady Urological Institute, Johns Hopkins Hospital, Baltimore, Maryland 21205.
The Journal of Urology
|May 1, 1993
Summary
Female epispadias, a rare congenital anomaly, requires careful urethral and genital reconstruction for successful bladder neck plasty. This approach achieved an 87.5% continence rate in 11 treated female patients.
Area of Science:
- Urology
- Pediatric Surgery
- Congenital Anomalies
Background:
- Female epispadias is a rare congenital anomaly.
- It can be overlooked as a cause of urinary incontinence.
- Treatment principles are similar to male epispadias, focusing on urethral and genital reconstruction.
Purpose of the Study:
- To evaluate the treatment outcomes for female patients with complete epispadias.
- To emphasize the importance of urethral channel creation and external genitalia reconstruction.
- To assess the success of bladder neck plasty in achieving urinary continence.
Main Methods:
- Retrospective review of 11 female patients with complete epispadias treated over 7 years.
- Surgical interventions included urethral reconstruction, external genital defect repair, and bladder neck plasty.
- Continence was assessed based on daytime and nighttime dryness.
Main Results:
- Nine patients underwent bladder neck plasty.
- An overall continence rate of 87.5% was achieved.
- Five patients achieved complete daytime and nighttime continence; three achieved daytime continence for >3 hours.
Conclusions:
- Female epispadias treatment requires meticulous attention to urethral channel creation and external genitalia reconstruction.
- Successful bladder neck plasty is achievable, leading to improved bladder capacity and urinary continence.
- The bladder in female epispadias behaves similarly to that in male epispadias, supporting similar surgical strategies.