Treatment of epispadias

Epispadias is a malformation of the urethra.

The disease is characterized by partial or complete splitting of the upper wall of the urethra. The disease can occur in people of both sexes.

In addition to the defect of the external genitalia, manifested by such serious violations: 

• urination with splashing of urine and often incontinence; 
• sexual dysfunction in adulthood, associated with painful erections and difficulty in sexual intercourse; 
• frequent urinary tract infections.

Urethral malformation is a congenital disease that is not common. According to the Cleveland Institute, epispadias is diagnosed in 1 in 117,000 male infants and 1 in 484,000 female children.

In most cases, epispadias occurs against a background of other congenital urologic problems, including exstrophy. Children with exstrophy are born with the bladder located outside the abdomen.

Total epispadias is the most severe form of this condition and is always accompanied by urinary incontinence. It borders on bladder exstrophy, in which the anterior wall of the bladder and the adjacent part of the abdominal wall are missing.

In both boys and girls, there is a divergence of the brow bones.

Symptoms of epispadias can be detected by a pediatrician in the process of examining the child. First of all, it is associated with external anomalies of the genitals. It can also be accompanied by frequent infections of the genitourinary system.

Abroad, and in particular in the leading hospital in Serbia, where epispadias is treated, the disease is diagnosed by means of examinations:

• blood tests to check electrolyte levels;
• intravenous pyelogram (IVP) – a special X-ray of the kidneys, bladder and ureters;
• MRI and CT scans, depending on the patient’s condition;
• pelvic x-rays;
• ultrasound of the genitourinary system.

Accurate diagnosis allows you to choose the safest and most effective method of epispadias treatment.

Epispadias is treated only surgically. The goal is to form a normal urethra and eliminate urinary incontinence. Serbian surgeons achieve an aesthetic effect by performing plastic surgery of the external parts of the genitals. 

Doctors choose the methods of urethra formation depending on the sex of the patient and the form of epispadias. 

In boys, straightening of the penis and lengthening of the urethra are performed. In girls, reconstruction involves bringing the clitoris together and moving the urethra into the correct position. 

If necessary, in children of both sexes, bladder neck plasty is performed with the formation of a bladder sphincter to eliminate urinary incontinence.

There are two types of surgical treatment used by doctors in foreign clinics. Both operations provide a normal appearance of the sexual organ with preservation of all functions.

Modified Cantwell technique

Cantwell-Ransley surgery involves reconstruction of the penis. In order to move the urethra to a more normal position, intervention on parts of the penis is required.

Mitchell Technique

Mitchell surgery involves completely disconnecting the penis and then connecting it back together. This is done so that the urethra is in its most functional and normal position and the dorsal curvature (chordia) is corrected.

Reconstruction in girls is less complicated than in boys. If diagnosed at birth, the two parts of the clitoris can be joined and the urethra placed in its normal position. 

If the problem is not diagnosed early or treated early, urinary incontinence can be corrected surgically as soon as it is discovered. If older girls or young women have a narrow vaginal opening, reconstruction is performed after puberty.

There is a specialized medical center in Belgrade, which performs complex interventions for the treatment of the genitourinary system. Sava Memorial welcomes patients of all ages.

The clinic’s leading doctor is the world-renowned surgeon and urologist Radoš Jinović. The team of specialists under the direction of Djinovic performs reconstructive surgeries of any complexity on patients from different countries.

Leave a request online so that Expert Medical coordinating doctors can organize your epispadias treatment in Serbia as soon as possible.

Expert Medical specialists will help you with such issues as:

• preliminary online consultation with a urologist from Serbia;
• transfer of medical documents to the clinic;
• booking of airplane tickets and airport transfer.

Expert Medical services are free of charge for patients. You pay for the surgery and postoperative care at the clinic’s cash desk.

Epispadias treatment in Serbia is a reliable option for solving a complex medical problem for reasonable money!