The document discusses the procedure for epispadias repair, which involves correcting a congenital absence of the dorsal wall of the urethra proximal to the glans penis in multiple stages. The first stage involves rotating the foreskin to cover the defect and mobilizing the distal urethra, while the second stage addresses creating the distal urethra and meatus, as well as repairing any defects in the bladder or prostatic urethra. The procedure may also include making a supra pubic incision to expose the prostatic urethra and suturing it with absorbable sutures to recreate the contin

1. EPISPADIAS REPAIR
Presented by----
Mrs. Usha Rani Kandula,
MSc.Nursing, Assistant professor,
Department of Adult Health Nursing,
College of Health Sciences,
Arsi University, Asella, Ethiopia.

2. DEFINITION
 Correction of a congenital absence of the
dorsal wall of the urethra proximal to the
glans penis.

4. URETHRAL MEATUS OPENS
 -The urethral meatus opens on the dorsal
aspect of the penis.
 -This deformity at the abdomino penile
junction
 -Associated with deformities of the bladder
and urinary sphincter.

5. NO CIRCUMCISION
 -Repair is necessary.
 -Circumcision should not be performed on
infants with epispadias
 -in order to preserve skin useful in correcting
the deformity.

6. FIRST STAGE REPAIR
 -The procedure may be staged;
 -The first stage involves the rotation of the
foreskin to cover the defect created by
mobilizing the distal urethra.

7. SECOND STAGE REPAIR
 -A second stage addresses the creation of the
distal urethra and meatus.
 -If defective, the bladder and prostatic urethra
are repaired.

8. PROCEDURE
 -When epi-spadias occurs in the distal penis,
the tissues are mobilized and sutured over the
defect.
 -The urethral meatus is opened at the tip of
the glans penis.

9. CREATING SUPRA PUBIC
INCISION
 -A supra pubic incision is made to expose the
prostatic urethra.
 -Redundant tissue of the prostatic urethra is
excised.

10. SUTURING WITH CATGUT
 -Absorbable sutures,
 e.g., catgut approximate the prostatic urethra
and vesical neck over a probe or catheter,
 -recreating the continence mechanism.

11. PLACEMENT OF SUPRAPUBIC
CYSTOSTOMY TUBE
 -A suprapubic cystostomy tube is placed to
provide temporary urinary diversion.
 -The skin is closed.

12.  -For Preparation of the Patient, Skin
Preparation, Draping, Equipment, and
Instrumentation, Supplies, and Special Notes,
see Hypospadias Repair,.

13. SUPPLIES
 Add suprapubic cystostomy catheter,
 e.g., Pezzer, Malecot.
 Thanking you.