Correction of adult epispadias after failed repair in childhood (SIU 2011)

  • uploaded: Jul 20, 2011
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Jul 20, 2011 / Duration: 09:38 / Views: 2062 / 0 comments

Authors:

Miroslav L. Djordjevic

Institution:

School of Medicine, University of Belgrade, Serbia

Abstract

Introduction and Objectives:Reconstruction of failed epispadias always presents a great challenge. We present a radical approach for correction of all severe penile deformities as well as urethral reconstruction in patient after failed epispadias repair.
Materials and methods: A 35 year-old man underwent two-stage surgery due to failed epispadias repair in childhood. First stage included penile disassembly which assumes complete separation of corporal bodies, urethral dissection and transposition and subtotal glans mobilization. Marked dorsal curvature was corrected by tunical incision and grafting. Short urethra was dissected and transposed ventrally with opening at the base of the penis. Penile entities were reassembled in normal anatomical relationship. Penile skin was reconstructed using remaining vascularized skin flaps. Three months later, missing penile urethra was created by combined buccal mucosa graft and scrotal hairless skin flap.
Results: Postoperatively good functional and esthetic results were achieved. Penis was completely straightened and lengthened. Patient reports normal sexual intercourse and regular voiding.
Conclusions: Redo surgery of failed epispadias could be very demanding procedure. Familiarity with variety of surgical techniques guarantees successful outcome and patient’s satisfaction.

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