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What is epispadias?

Epispadias is a rare congenital condition where the urethral opening (the tube through which urine exits the body) is not located at its usual place at the tip of the penis in males, or in the area between the clitoris and vagina in females, but is positioned on the upper side of the penis or above the normal position in females. In males, this condition can affect both the appearance and function of the penis, sometimes accompanying a curvature of the penis (chordee) and making urination difficult. Epispadias can be part of a more complex condition known as bladder exstrophy, but it can also exist independently.

Diagnosis

The diagnosis of epispadias is usually made based on a physical examination immediately after birth. In addition to the physical examination, further tests such as ultrasound may be required to assess accompanying anomalies in the urogenital tract. Sometimes, a more detailed evaluation may be necessary to plan appropriate therapy, especially in more complex cases.

Treatment

The treatment of epispadias typically involves surgical intervention aimed at correcting the position of the urethral opening and improving the function of the urethra, as well as the aesthetic appearance of the genitals. The complexity of the surgical intervention can vary depending on the degree of epispadias and accompanying anomalies. In most cases, surgery is recommended at an early age, often before the first year of life, to allow for normal development and reduce the possibility of complications.
In addition to surgical treatment, a multidisciplinary team approach that may include a pediatric urologist, nephrologist, and, if necessary, a psychologist, can be beneficial in providing comprehensive support to children and their families through the treatment and rehabilitation process. The goal of treatment is not only to correct physical anomalies but also to ensure normal development and psychosocial well-being of the child.