The primary motto of treatment of exstrophy epispadias repair is to:
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Straighten and lengthen the penis by correcting dorsal bend and chordee.
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To create the functionality and cosmetically suitable exterior genitalia with as only some surgical methods as possible. If the bladder and bladder neck are involved, surgical treatment is necessary to create urinary continence and preserve fertility.
PROCEDURE:
There are two main surgical treatments that will achieve these objectives.
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The first objective is customized Cantwell technique; this procedure may involve partial disassembly of the penis and then placement of the urethra in a original position.
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The second technique is the most recent development of the modern epispadias repair is the total disassembly of the penis into its divide the components – 2 corpora cavernosa and a 1 corpus spongiosum. Followed by disassembly of the 3 components are reassembled such that the urethra is in normal position and most functional and the dorsal chordee is rectified. Both the above techniques will provide a straight urethra located on the underside of the penis, correction of chordee and an acceptable cosmetic result. The disassembly method has a lower difficulty rate and facilitates both bladder and bladder neck repair. Sometimes, boys with the exstrophy-epispadias complex are born with a very tiny or severely underdeveloped or undersized penis. In these cases, surgical rebuilding of the penis is much more difficult, and sometimes reserved for whole phalloplasty.
Children who are suffering with exstrophy-epispadias complex may surely require a surgical treatment to develop the urethral resistance (bladder neck repair). Yet the new treatments of primary repair at birth permits almost 1/3rd of the patients to achieve urinary control without the need for other procedures.
