Epispadias

What is epispadias?

Epispadias occurs when the urethral opening, the tube that drains the urine from the bladder to the outside of the body, is not in the correct location. Epispadias can occur alone, but usually occurs in conjunction with bladder extrophy, which is a combination of disorders that occurs during fetal development. 

When this condition occurs in boys, the urethra opens on the top side of the penis, instead of at the tip. In girls, the urethral opening is bigger and longer than normal, positioned further up the urethral tube, and can extend all the way to the bladder.

Why come to Children's Hospital Colorado for treatment of this condition?

The professionals at Children's Hospital Colorado in Aurora, Colorado are dedicated to caring for kids. The members of the urology team are experts in pediatric urologic conditions and our surgeons are specialized in both pediatrics and urology. We strive to help patients and families feel educated about their condition, prepared for treatment and fully cared for by our urology team. 

What are the signs and symptoms?

In boys the penis is typically short and broad and the urethral opening located on the top side of the penis.   From the location of the abnormal opening to the tip, the penis may be split. There may also be an abnormal curvature of the penis toward the abdomen. 

Girls will have a narrow vaginal opening, wide labia, split clitoris, and a short urethra.   Wide pubic bones, urinary tract infections, urinary incontinence and reflux of urine into the kidneys are also symptoms of epispadias. 

How do you diagnose it?

The diagnosis of epispadias typically happens at birth. If the malformation is not severe, it may be diagnosed when the child (usually female) continues to have wetting after potty training.

How is it treated?

The primary goal of treatment is to create typical-looking external genitalia that functions well.    In boys, surgical treatment is performed to maximize penile length and function by correcting the bend in the penis and moving the urethra so the boy pees from the end of the penis. In girls, this means fusing the clitoris, moving the urethra, and repairing the bladder’s control mechanism to prevent urinary leaking.

Who gets it and can it be prevented?

Epispadias is a very rare congenital defect affecting 1 in 117,000 newborn boys and 1 in 484,000 newborn girls.

When should I seek medical attention?

A pediatric urologist should be consulted when you or the child’s pediatrician have any concerns about the genitourinary tract appearance or function.