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Penile Epispadias Reconstruction Workup

  • Author: Fabio Santanelli di Pompeo, MD, PhD; Chief Editor: Jorge I de la Torre, MD, FACS  more...
 
Updated: Nov 04, 2015
 

Laboratory Studies

See the list below:

  • Obtain a complete blood cell count.
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Imaging Studies

See the list below:

  • Obtain a chest radiograph if indicated based on examination findings or the patient's history.
  • Radiologic (eg, intravenous pyelogram) and ultrasound evaluations of the urogenital system (eg, kidneys, ureters, bladder; urethra, genitalia) are usually necessary to evaluate the extent of the defect. (For more information on bedside ultrasonography of the kidneys, see Medscape Reference article Obstructive Uropathy Assessment using Bedside Ultrasonography.)
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Other Tests

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  • Obtain an ECG for operating room guidelines.
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Contributor Information and Disclosures
Author

Fabio Santanelli di Pompeo, MD, PhD Associate Professor of Plastic Surgery, Sapienza University of Rome School of Medicine and Psychology; Chief of Plastic Surgery Unit, Sant'Andrea Hospital, Rome

Fabio Santanelli di Pompeo, MD, PhD is a member of the following medical societies: American Society of Plastic Surgeons, International Confederation for Plastic and Reconstructive and Aesthetic Surgery, European Association of Plastic Surgeons, Societa Italiana di Microchirurgia, Swedish Associations of Plastic Surgeons, Osservatorio Nazionale Identit? di Genere

Disclosure: Nothing to disclose.

Coauthor(s)

Francesca Romana Grippaudo, MD, PhD Assistant Professor, Department of Plastic Surgery, S Andrea Hospital, Faculty of Medicine and Psycology, Sapienza University of Rome, Italy

Francesca Romana Grippaudo, MD, PhD is a member of the following medical societies: International Confederation for Plastic and Reconstructive and Aesthetic Surgery, Italian Society of Plastic Reconstructive Surgery and Aesthetics

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Jorge I de la Torre, MD, FACS Professor of Surgery and Physical Medicine and Rehabilitation, Chief, Division of Plastic Surgery, Residency Program Director, University of Alabama at Birmingham School of Medicine; Director, Center for Advanced Surgical Aesthetics

Jorge I de la Torre, MD, FACS is a member of the following medical societies: American Burn Association, American College of Surgeons, American Medical Association, American Society for Laser Medicine and Surgery, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, American Society for Reconstructive Microsurgery, Association for Academic Surgery, Medical Association of the State of Alabama

Disclosure: Nothing to disclose.

Chief Editor

Jorge I de la Torre, MD, FACS Professor of Surgery and Physical Medicine and Rehabilitation, Chief, Division of Plastic Surgery, Residency Program Director, University of Alabama at Birmingham School of Medicine; Director, Center for Advanced Surgical Aesthetics

Jorge I de la Torre, MD, FACS is a member of the following medical societies: American Burn Association, American College of Surgeons, American Medical Association, American Society for Laser Medicine and Surgery, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, American Society for Reconstructive Microsurgery, Association for Academic Surgery, Medical Association of the State of Alabama

Disclosure: Nothing to disclose.

Additional Contributors

Dennis P Orgill, MD, PhD Professor of Surgery, Harvard Medical School; Associate Chief of Plastic Surgery, Brigham and Women's Hospital

Dennis P Orgill, MD, PhD is a member of the following medical societies: American Society for Reconstructive Microsurgery, Plastic Surgery Research Council, American Medical Association, Massachusetts Medical Society

Disclosure: Received consulting fee from Integra LifeSciences, Inc for consulting; Received consulting fee from Integra LifeSciences, Inc. for program and training services agreement; Received grant/research funds from Integra LifeSciences, Inc. for clinical research; Received grant/research funds from KCI for basic science research; Received grant/research funds from KCI for clinical research; Received consulting fee from DSM for consulting; Received consulting fee from Musculoskeletal Transplant Foundatio.

References
  1. Kureel SN, Gupta A, Singh CS, Kumar M. Surgical anatomy of penis in exstrophy-epispadias: a study of arrangement of fascial planes and superficial vessels of surgical significance. Urology. 2013 Oct. 82(4):910-6. [Medline].

  2. Ben-Chaim J, Peppas DS, Jeffs RD, Gearhart JP. Complete male epispadias: genital reconstruction and achieving continence. J Urol. 1995 May. 153(5):1665-7. [Medline].

  3. Mollard P, Basset T, Mure PY. Male epispadias: experience with 45 cases. J Urol. 1998 Jul. 160(1):55-9. [Medline].

  4. Surer I, Baker LA, Jeffs RD, Gearhart JP. The modified Cantwell-Ransley repair for exstrophy and epispadias: 10- year experience. J Urol. 2000 Sep. 164(3 Pt 2):1040-2; discussion 1042-3. [Medline].

  5. Mokhless I, Youssif M, Ismail HR, Higazy H. Partial penile disassembly for isolated epispadias repair. Urology. 2008 Feb. 71(2):235-8. [Medline].

  6. Kibar I, Roth C, Frimberger D, Kropp BP. Long-term results of penile disassembly technique for correction of epispadias. Urology. 2009/03. 73:510-4.

  7. Hafez AT, Helmy T. Complete penile disassembly for epispadias repair in postpuberal patients. Urology. 2011/12. 78:1407-10. [Full Text].

  8. Stewart D, Inouye BM, Goldstein SD, et al. Pediatric surgical complications of major genitourinary reconstruction in the exstrophy-epispadias complex. J Pediatr Surg. 2015 Jan. 50 (1):167-70. [Medline].

  9. Kramer SA, Mesrobian HG, Kelalis PP. Long-term followup of cosmetic appearance and genital function in male epispadias: review of 70 patients. J Urol. 1986 Mar. 135(3):543-7. [Medline].

  10. Kertai MA, Rosch WH, Brandl R, Hirschfelder H, Zwink N, Ebert AK. Morphological and Functional Hip Long-Term Results after Exstrophy Repair. Eur J Pediatr Surg. 2015 Oct 7. [Medline].

  11. Reddy SS, Inouye BM, Anele UA, et al. Sexual Health Outcomes in Adults with Complete Male Epispadias. J Urol. 2015 Oct. 194 (4):1091-5. [Medline].

  12. Kollhoff DM, Cheng EY, Sharma AK. Urologic applications of engineered tissue. Regen Med. 2011 Nov. 6(6):757-65. [Medline].

  13. Caione P, Boldrini R, Salerno A, Nappo SG. Bladder augmentation using acellular collagen biomatrix: a pilot experience in exstrophic patients. Pediatr Surg Int. 2012 Apr. 28(4):421-8. [Medline].

  14. Gearhart JP. Re: results of complete penile disassembly for epispadias repair in 42 patients. J Urol. 2004 Jun. 171(6 Pt 1):2386; author reply 2386. [Medline].

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Distal penile epispadias.
Wide diastasis of the pubic bone and external displacement of the hips in epispadias.
Distal epispadias. Outlining of local flaps from the glans to reconstruct the distal urethra.
Reconstruction of distal penile urethra using local flaps (arrows).
Vertical island flap drawn on the ventral aspect of the penis.
Island flap transferred dorsally and anastomosed to the urethra.
Island flap sutured into a tube to reconstruct the missing portion of the urethra.
Urethral reconstruction is completed.
Drawing of the final appearance at the end of the operation.
Photograph of the final appearance at the end of the operation.
 
 
 
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