[Reconstruction of congenital female epispadias]

In female epispadias complete repair of the wide and short urethra and bladder neck abnormalities facilitate achievement of bladder regrowth with adequate bladder capacity and urinary continence. Attention must be given to correct the appearance of malformed anatomy of the external genitalia which is of importance for later sexual function. Eight cases are described of congenital female epispadias and incontinence treated during the years 1964-1995. Of these patients, 2 had had failed previous procedures. Eight patients underwent bladder neck plasty and creation of an adequate urethral channel using a combined perineal and transvesical approach. Ureters were reimplanted in five cases if they had VUR reflux or facilitate bladder neck plasty. Simultaneous genitourinary reconstruction of the external genital defect, monsplasty, creation of urethral channel and bladder neck plasty were performed in 6 patients and in two as a secondary procedure. Five patients are completely continent day and night, two patients are dry, but during the day they are a little stress incontinent. One patient underwent urinary diversion after she failed one bladder neck procedure.