Epispadias

Access exceptional care for epispadias at Montefiore Einstein Urology at the Children’s Hospital at Montefiore Einstein (CHAM). As a leader in urology, we are an academic-based referral site for the most complex and high-risk cases. For more than a century, we have been at the forefront of innovation, research and clinical care for genitourinary (GU) conditions.

Montefiore Einstein continues to make advances in the diagnosis and treatment of GU conditions. Our multidisciplinary team of specialists is passionate about uncovering diagnostic approaches and treatments that can improve outcomes.

At Montefiore Einstein Urology, you can expect compassionate research-based treatment plans that meet the highest standards for quality and safety. We are committed to ensuring your child will receive the best patient- and family-centered care in a supportive and nurturing environment.

When you want only the best for your child, turn to our dedicated providers who will develop a highly personalized treatment plan.

What Is Epispadias?

Epispadias is a rare congenital anomaly characterized by the abnormal development of the urethra, the tube that empties urine from the bladder. This rare birth defect affects both male and female babies, causing urethral and genital malformations and dysfunction. Epispadias can be associated with other birth defects such as cloacal exstrophy, a condition in which an inside-out bladder protrudes from the abdomen. Surgery is required to correct and treat severe cases of epispadias.

Causes of Epispadias

The cause of epispadias is unknown but may be associated with other types of abnormal fetal organ development, such as cloacal exstrophy or improper development of the pelvic bone.

Signs & Symptoms of Epispadias

Females with epispadias may experience the following symptoms:

  • Malformation of the pelvic bones, causing the clitoris to split into two halves
  • Urinary incontinence

Males with epispadias may experience the following symptoms:

  • Pelvic bone abnormalities, causing upward curvature of the penis
  • Urinary incontinence

Diagnosing Epispadias

Epispadias is typically diagnosed at birth during a physical examination of the newborn. Mild cases are often not discovered until later in childhood. Additional tests that may be used to confirm diagnosis include:

  • Blood tests
  • Computed tomography (CT) scan
  • Intravenous pyelogram (an advanced X-ray of the kidneys, bladder and ureter) 
  • Magnetic resonance imaging (MRI)
  • Ultrasound
  • X-rays

Treating Epispadias

Patients with epispadias may require reconstructive surgery. The type of surgery depends on the nature and severity of the condition, as well as the patient’s gender at birth. The goal of any surgical approach is to restore full urinary control and correct any abnormalities in the appearance of the genitalia. Reconstructive surgery in females typically involves repairing the split clitoris and repositioning the urethra. In cases of male epispadias where the penis is bent or misshapen, two surgical techniques may be used:

  • The Mitchell technique: Surgeons reposition the urethra and fix any penile curvature by reconstructing the penis.
  • The modified Cantwell-Ransley technique: Surgeons reposition the urethra by reconstructing the penis.

Any incontinence issues that persist after reconstructive surgery are often treated later in life with other types of surgeries.