Causes and risk factors
The exact cause of epispadias is unknown. It is due to improper development of the pubic bone. Epispadias can be associated with bladder exstrophy, an uncommon birth defect in which the bladder is exposed inside out and sticks through the abdominal wall.
Clinical presentation
Males with epispadias present with short wide penis with abnormal curve. There is abnormal curvature of penis with opening abnormally placed. It leads to recurrent UTI and swelling. Urine exits either form the side or form the top of the penis instead of the tip. In females, there is abnormal clitoris and labia. The urethra opens between the clitoris and labia, but in this condition it maybe in the belly area. Urinary incontinence is experienced.
Investigation
Medical history by the patient and clinical examination by the doctor helps in diagnosis. The condition is usually diagnosed at birth or soon after the birth. Blood test to check electrolyte levels are done. Intravenous pyelogram [IVP], a special x-ray of the kidneys, bladder, and ureters is recommended. Pelvic x-ray is required. Ultrasound of the urogenital system is advised.
Treatment
Surgical repair of the genitourinary tract is the recommended treatment for epispadias. A second surgery may be needed to correct leakage of urine.
