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Complete male epispadias: genital reconstruction and achieving continence.
Journal of Urology 1995 May
We report on 15 patients who were primarily treated for complete male epispadias at our institution since 1975. Repair of epispadias was performed using a modified Young urethroplasty in 13 patients and a Cantwell-Ransley urethroplasty in 2. In addition, 2 patients underwent a Cantwell-Ransley urethroplasty with chordee repair after a previous Young urethroplasty failed. Bladder capacity increased from a mean of 50 cc before repair to 92 cc after urethroplasty. A urethrocutaneous fistula developed in 6 cases, including 5 Young repairs and 1 Cantwell-Ransley. Three fistulas resolved spontaneously and there were no urethral strictures. Bladder neck reconstruction was performed in 11 patients. Time to initial continence ranged from 21 days to 6 months (mean 3 months) postoperatively. All patients attained daytime continence in a mean of 9 months (range 21 days to 24 months) after bladder neck reconstruction, including 9 of 11 (82%) who achieved total day and night continence. Mean followup was 7 years (range 1 to 10). Modern treatment of complete male epispadias allows for an excellent genital appearance and achievement of urinary continence.
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