A new technique in management of female epispadias

1. INTRODUCTION
Female epispadias - very rare [1 in 484000 ]
Male:Female :: 3:1 to 4:1
TYPES
Vestibular
Subsymphysial/penopubic
Retrosymphysial

2. 6 cases managed since 1991
4 cases – results published [sept.2008]
2 cases – penopubic epispadias with total incontinence
[5 yr & 7 yr]
Perineal urethroplasty with double breasting,
sphincteroplasty and genital reconstruction.

3. Steps
1. Mobilisation of urethral plate .
2.Denudation of urethral strip.
3. Tubularisation of urethra. Mobilisation of urethral plate
4. Double breasting of urethral plate
& trigonal flap.
5. Corporoplasty, sphincteroplasty, & genitoplasty.

6. Both patients - fully continent
- dry interval of 4 to 5 hrs/day
one had nocturnal enuresis –
responded to anticholinergics

7. The technique utilizes both bladder
& urethral factors for continence.
Simple, effective and reproducible technique –
for continence and cosmesis