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International Urology and Nephrology

, Volume 51, Issue 4, pp 579–583 | Cite as

Complete penile disassembly in epispadias repair

  • Smail AcimiEmail author
  • Mohammed Ali Acimi
Urology - Original Paper
  • 27 Downloads

Abstract

Purpose

To report current results of complete penile disassembly technique in epispadias repair.

Methods

In ten years, we have preformed 31 complete penile disassembly for proximal epispadias repair. Twenty-four patients had epispadias after primary repair of bladder exstrophy and 7 isolated penopubic epispadias. The age of the patients ranged from 10 months to 6 years (median 3 years).

Results

The shortening of urethral plate was found in 30 patients (97% of cases), and this shortening varied between 6 and 16 mm. However, in one patient we found a lengthening of the urethral plate of 8 mm. The narrowing of urethral plate was found in all patients, and this narrowing varied between 30 and 50% of the width of the plate. Postoperative complications encountered in our patients were dominated by fistulas and dehiscence, particularly in patients who had bladder exstrophy–epispadias complex. After dehiscence and fistulas repair, the cosmetic results were satisfying in 25 patients (80.5% of cases) with conical glans and meatus in orthotopic position without any necrosis of the glans. However, the urinary continence ≥ 1 h was observed in 6 patients (19% of cases) and only 3 patients (9.7% of cases) had a urinary continence ≥ 3 h. The mean follow-up was 61 months.

Conclusions

The complete penile disassembly remains one of the best techniques for epispadias repair. However, we noticed a reappearance of the dorsal curvature of the penis in a large number of patients treated for isolated epispadias and the impact of this technique on urinary incontinence remains uncertain.

Keywords

Bladder exstrophy Urinary continence Epispadias Complete penile disassembly Mitchell’s technique 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study conforms to the World Medical Association Declaration of Helsinki (June 1964) and subsequent amendments and the investigations were carried out to a high ethical standard. However, in our country, there is no formal and documented ethical approval from an appropriately constituted research ethics committee, which requires to be obtained for all studies involving human.

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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Department of Visceral Surgery, Children’s Hospital Canastel, Faculty of MedicineUniversity Of OranOranAlgeria
  2. 2.Department of Surgery, EHU Oran, Faculty of MedicineUniversity Of OranOranAlgeria

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