Epispadia: symptoms, causes, to treatment

Definition

What is epispadia?

Epispadia is a rare congenital condition that involves the opening of the urethra (the tube through which urine passes from the bladder). In this condition, the tube that passes urine from the body is in the wrong place.

In male babies, the hole is at the top of the penis. In this condition, the opening may be all over the top of the penis.

In baby girls, the opening can also be longer and higher in the urethra. It may open right next to the bladder.

How common is this condition?

This is a fairly rare genetic condition. Epispadia cases are found as many as one in 10,000-50,000 people.

Types

What are the different types of epispadia?

Epispadia can occur on its own, but generally it comes along with other conditions, such as more severe urinary tract problems, bladder problems, pelvic problems, incomplete abdominal wall formation, or even an abnormal rectal location.

These various conditions associated with epispadia are referred to as the exstrophy-epispadias complex.

Exstrophy-epispadias complex

Approximately 10% of patients with epicpadia do not have any of the other problems that come with this condition. However, the other 90% have an exstrophy-epispadias complex, which is when epispadia co-exists with other conditions.

This condition is more common than epispadia that presents itself alone. Quoted from Very Well Health, this condition affects 1 in 30,000 babies.

Bladder ecstrophy is one of the more common conditions associated with epispadia and is usually diagnosed during pregnancy. This condition is caused by incomplete closure of the stomach, so that the bladder can be seen.

Other conditions that usually present with epispadia are small genitalia, absent pubic bones, pelvic changes, anus in an odd position, and an inguinal hernia.

These problems arise together because they form during the period of fetal development in the womb. These different areas form at the same stage of development, so distraction during this crucial time causes problems.

Types of epispadia in men

The opening in the penis where urine exits the body is called the urinary meatus. Usually, this hole is at the tip of the penis. However, in men with epicpadia, this opening appears along the top of the penis.

The following are the types of penile disorders:

• Penopubic epicpadia, that is, when the urinary meatus is found close to the body. It is located not on the penis, but near the pubic bone at the base of the penis.
• Penile epicpadia, which is when the urinary meatus is found on the shaft of the penis, anywhere before the head of the penis and above the base where the shaft meets the body.
• Glispular epicpadia, that is, when the urinary meatus is found at the head of the penis, but at the top of a common location at the tip.

Epispadia in women

In women, Epispadia is usually the maid along with other conditions. Conditions without other additional problems affecting the bladder, kidneys, or urethra are rare. This condition is seen as an abnormal space between the pubic bones that is not present in the normal anatomy.

This condition can be found with other problems, such as a short vagina that may require stretching to support sexual intercourse in adulthood, problems with the bladder or urethra, and other conditions that affect urination.

Symptoms

What are the signs and symptoms of epispadia?

Reporting from Medline Plus, the symptom of the condition in men is a short and wide penis with an abnormal curvature. The urethra is most often open at the top or side of the penis, not at the tip. An open urethra along the penis is also possible.

In women, this condition is characterized by an abnormal clitoris and labia. The urethral opening is often between the clitoris and the labia, but it is in the abdominal area.

Women with this condition may have difficulty controlling urination (urinary incontinence).

Cause

What causes this abnormal position of the penile opening?

Epispadia occurs due to the formation of the genital organs that are not perfect when entering the 5th week of pregnancy. It is often difficult or impossible to know what causes the fetus to not develop properly during certain developmental days.

Although epispadia is caused by abnormalities in the process of organ formation, it is rarely seen in two people in the same family.

Risk factors

What are the risk factors for this condition?

Men are four times more likely to develop epispadia than women. The chance of epispadia is dramatically higher in children than individuals who are born with the same condition. Chances are 1 in 70 children are born with this type of congenital problem.

Diagnosis and treatment

How do doctors diagnose this condition?

This condition is usually diagnosed by the appearance of the genitals, shortly after birth. This diagnosis often requires additional tests to determine if additional areas of the urinary tract are involved.

Examinations may include:

• Blood test
• Intravenous pyelogram (IVP), a special x-ray of the kidneys, urinary tract, and ureters
• MRI and CT scans, depending on the condition
• Pelvic X-ray
• Ultrasound of the urinary system and genitals.

In more severe cases, parents can receive counseling and education about epicpadia and related conditions. Delivery is usually done in a health facility that is able to provide immediate care for babies with this condition.

How is epispadia treated?

In cases of epispadia and hypospadias, the doctor will perform reconstructive surgery. The operation is performed to restore the shape of the penis to normal. The operation is also done so that the penis can grow normally.

There are various methods of reconstruction operations ranging from one-stage to two-stage. This surgery is recommended for preschool children so as not to interfere with learning activities during surgery. Here's the review:

• Stage 1: This operation can be done when your baby is 48 hours old. The bladder is inserted into the body and the stomach is closed.
• Stage 2: This operation can be performed at 6 months of age. These actions include correcting epispadia and other genital problems.
• Stage 3: This procedure is performed around the age of 4 to 5 years. This is when the bladder is large enough. This age is also the time when children are ready to stay dry. This last operation is performed to rebuild the urinary tract, including the bladder and tubes.

Keep in mind that often this reconstructive operation requires more than one operation, re-correction if complications occur.

If you have any questions, consult your doctor for the best solution to your problem.

Hello Health Group does not provide medical advice, diagnosis or treatment.