Complete Penile Disassembly for Epispadias Repair
Over the past six years we have used a technique for epispadias repair which is based on the unique anatomy of the epispadias deformity which is actually a deformation rather than a malformation (e.g. as in hypospadias). In this technique the unique and separate blood supply of the urethral plate, the glans penis and the corpora cavernosa facilitate complete disassembly of the penis which enables reassembly resulting in normal anatomic position of the urethra and bladder neck. This repair also enables complete and independent rotation of the corpora cavernosa to better correct the dorsal deflection deformity.
This technique has made possible reconstruction in staged exstrophy closures, but more importantly has realized the potential for primary complete reconstruction of the male exstrophy patient. It can also be applicable to redo reconstructions in epispadias patients who have had multiple procedures as it facilitates reconstruction with flap urethroplasties or grafts (buccal mucosa).
This procedure facilitates the tubularization and ventralization of the entire distal urethra/complete glans repair and results in a normal appearing phallus. In primary repair patients the resultant urethra is straight and easily catheterized.
KeywordsBladder Neck Tunica Albuginea Corporal Body Glans Penis Urethral Plate
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