Data from 113 individuals were gathered from the bladder-exstrophy-epispadias database of their tertiary facility. A total of 7 boys with isolated penopubic epispadias with no prior history of surgery and any other abnormalities underwent the modified surgical method from February 1997 to September 2019. The mean ± SD age at operation was 6.5 ± 2.4 years. Volitional voiding status and aesthetic appearance were examined at each follow-up interval. Postoperative follow-up was performed quarterly in the first year and once a year in the following years. The mean ± SD of follow-up was 8.5 ± 6 years. All boys who were incontinent achieved urine control and the ability of normal transurethral micturition following the procedure. About 4 lads went fully dry, and the other 3 acquired social dryness. Postoperative mean (SD) bladder capacity was dramatically enhanced from 54.5 (11) to 124 (40.0) within 6 months, and to 194 (47.5) after 18 months after surgery. Dorsal curvature has been addressed in all cases, and no postoperative problems were detected except for surgical site infection in 1 patient treated with antibiotics, and bilateral vesicourethral reflux was cured following injection of bulking agents. About 4 patients exhibited normal erectile function and ejaculation, while the others had not reached puberty yet. Penile ischemia, stricture, or urethrocutaneous fistula did not occur in any patients. The results presented here support using a single-stage urethro-genitoplasty in conjunction with a bladder neck plication and a fat pad pedicled flap to treat boys with an isolated penopubic epispadias. This approach is safe and effective in improving urinary control, sexual function, and genital aesthetics. Essential elements supporting the idea of presenting this procedure as a credible choice for the care of this entity include minimal morbidity, a low complication rate, and promising outcomes.
Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-022-01089-2
