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11–14 APRIL, 2018, HELSINKI, FINLAND
15:07–15:10
S18-2 (PP)
LONG TERM OUTCOMES OF MALE EPISPADIAS
Johanna THOMAS
1
, Manoj SHENOY
2
, Imran MUSHTAQ
1
and Dan WOOD
3
1) Great Ormond Street Hospital for Children NHS Foundation Trust, Urology, London, UNITED KINGDOM -
2) Nottingham University Hospital, Paediatric Urology, Nottingham, UNITED KINGDOM - 3) University College London
Hospital NHS Foundation Trust, Urology, London, UNITED KINGDOM
PURPOSE
Isolated male epispadias is rare with a reported incidence of 1 in 117,000. We present a series
of 30 male patients presenting with primary epispadias between 1989–2002. We looked at the
number of surgical procedures undertaken, continence and sexual function.
MATERIAL AND METHODS
We looked at Male primary epispadias patients from our database who had gone through transition
into the Adolescent service. This was a retrospective review looking at age of presentation, age
of primary surgery, need for further surgery, continence and sexual function. The information was
based on outpatient documentation.
RESULTS
We identified 58 patients and obtained follow-up data in 30 (sub-symphyseal 21, penile 9).
Follow-up ranged from 15–27 years. Primary surgery took place between 9–48 months. 22 had
Cantwell-Ransley repair, 3 had a tumble-type repair, 1 had a reversed Duckett repair and 4 had their
primary surgery at another centre. 28 patients needed further surgery during follow-up: continence
procedures (26) and revision surgery (12). Continence procedures included injection of bulking
agents, bladder neck reconstruction and Kelly procedure. At follow-up 15 were continent requiring
no protection, 9 reported stress leakage, 6 voided using a Mitrofanoff, 4 of these had an ileocys-
toplasty. 19 patients had documentation on feelings regarding cosmesis; 17 expressed concern.
21 patients had documentation about sexual function; all 21 had normal erections with 6 reporting
chordee and 9 reporting retrograde ejaculation. 4 patients had surgery in adulthood for cosmesis.
No patients were recorded to have fathered any children, 2 had sought fertility advice.
CONCLUSIONS
There are very few studies looking at the long-term follow up of patients with primary epispadias.
We have demonstrated here favourable outcomes which will be useful for clinicians in counselling
patients and their parents.
15:10–15:16
Discussion