Epispadias

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Related to Epispadia: Hypospadia

epispadias

[‚ep·ə′spād·ē·əs]
(medicine)
A congenital defect of the anterior urethra in which the canal terminates on the dorsum of the penis and posterior to its normal opening.

Epispadias

 

a congenital defect of the urethra, in which the anterior wall is totally or partially absent. Epispadias occurs more often in men than in women. The dorsal surface of the penis or clitoris has a groove that constitutes the posterior and lateral walls of the urethra. The three main types are balanic epispadias, which is limited to the glans penis; penile epispadias, which involves part of the body of the penis; and penopubic epispadias, in which the urethra is completely split and the urinary bladder sphincters are absent. Epispadias may cause spraying of the urine stream, impairment of sexual function, and urinary incontinence. The condition may be treated surgically by burying the rudimentary groove between the cavernous bodies of the penis and restoring the urinary bladder sphincters.

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One-year-old male patient, ASA I/VI, weighing 13 kg, with a diagnosis of bladder exstrophy and epispadias, scheduled for exstrophy correction, bilateral pelvic osteotomy and external fixator placement had inhaled induction with sevoflurane, balanced general anaesthesia, access with #20 venous catheter in the right upper limb, central left external jugular vein catheter, right radial arterial line, analgesia with caudal tunnelled catheter (Fig.
The bladder extrophy and epispadias complex represents an additional challenge.
Boys who are born with epispadias or classic exstrophy have a congenital absence of the urethral sphincter mechanism.
It also causes reduced AGD, retained nipples, and low incidence of epispadias (1:13).
This anomaly may be accompanied by various pathological conditions including hypospadias epispadias anterior urethral valve lacuna manga prostatic urethral polyps megalo-urethra syringocele (dilated Cowper gland) and congenital urethral fistula.
Males born with penile anomalies (hypospadias, epispadias or megalourethra) and children with ammonia dermatitis were excluded from the study.
The EEC covers a spectrum with different severity levels, ranging from epispadias (E) representing the mildest form, with lower and upper fissure, to the full picture of classical bladder exstrophy (CEB), and exstrophy of the cloaca (EC)--often also referred to as OEIS (omphalocele, exstrophy, imperforate anus and spinal defects) complex--as the most severe form.
This is especially true of patients with bladder exstrophy who typically have a very tortuous urethra after epispadias repair and bladder neck reconstruction.