M E Mitchell1, D J Bägli. 1. Division of Pediatric Urology, Children's Hospital and Medical Center, Seattle, Washington 98105, USA.
Abstract
PURPOSE: We report a new technique for epispadias repair, which relies on the unique blood supply of the corpus cavernosum and glans. The epispadiac phallus is completely disassembled into 3 discrete components: the urethral plate, and the right and left hemicorporeal glandular bodies. MATERIALS AND METHODS: Ten boys 10 months to 17 years old presented for repair of epispadias between 1990 and 1994 (6 primary and 4 secondary repair). One patient underwent bladder exstrophy closure at the time of epispadias surgery. Two patients underwent prior para-exstrophy flap procedures and neither had fistulas. RESULTS: Followup (8 to 57 months) revealed a conical glans in 8 patients, straight shaft upward in 1 and ventral orthotopic meatus in 7. In 2 patients who underwent secondary repair 3 fistulas formed that were repaired on an outpatient basis. All patients are potent. CONCLUSIONS: Complete disassembly allows tubularization and ventralization of the entire distal urethra; makes glans and urethral repair independent; separates the 2 corporeal glandular bodies, permitting easier and more complete release of the rotation contributing to dorsal chordee, and improves exposure for corporotomy or dermal grafts.
PURPOSE: We report a new technique for epispadias repair, which relies on the unique blood supply of the corpus cavernosum and glans. The epispadiac phallus is completely disassembled into 3 discrete components: the urethral plate, and the right and left hemicorporeal glandular bodies. MATERIALS AND METHODS: Ten boys 10 months to 17 years old presented for repair of epispadias between 1990 and 1994 (6 primary and 4 secondary repair). One patient underwent bladder exstrophy closure at the time of epispadias surgery. Two patients underwent prior para-exstrophy flap procedures and neither had fistulas. RESULTS: Followup (8 to 57 months) revealed a conical glans in 8 patients, straight shaft upward in 1 and ventral orthotopic meatus in 7. In 2 patients who underwent secondary repair 3 fistulas formed that were repaired on an outpatient basis. All patients are potent. CONCLUSIONS: Complete disassembly allows tubularization and ventralization of the entire distal urethra; makes glans and urethral repair independent; separates the 2 corporeal glandular bodies, permitting easier and more complete release of the rotation contributing to dorsal chordee, and improves exposure for corporotomy or dermal grafts.