Epispadias - Penis Reconstruction and Incontinence Management

Epispadias is a rare congenital anomaly in which the urethral opening is located on the upper side of the penis, not at the tip. In mild forms, the anomaly may affect only the penis without major functional problems. In more severe cases, epispadias can affect the normal functioning of the bladder and urinary control, and may be associated with incontinence.

The diagnosis of epispadias is usually made based on a physical examination immediately after birth. Sometimes additional diagnostic procedures such as ultrasound, cystoscopy (examination of the inside of the bladder with a camera), or urodynamic tests that assess how the bladder stores and releases urine are needed. These studies help determine the degree of impact of epispadias on bladder and urethral function.

Treatment of epispadias involves surgical reconstruction of the penis and, if necessary, addressing incontinence. The goal of the surgery is to place the urethral opening in the anatomically correct position and to improve the aesthetic appearance of the penis. Surgery is usually planned in early childhood to avoid psychological and physical problems later in life.
When incontinence is a problem, treatment may consist of additional surgical interventions on the bladder and sphincters, which control the expulsion of urine. In some cases, the implantation of a device that helps control the release of urine may be necessary. As a support to surgical treatment, physiotherapy and exercises to strengthen the pelvic floor muscles may be recommended to improve bladder control.