Epispadias: recent techniques

Aim: This paper presents the latest surgical approaches for epispadias treatment in pediatric population, as well those adolescent and adult populations after initial failed repair childhood. Methods: The retrospective study was conducted between March 2005 May 2020 included 18 patients with mean age of 21 months (range 11-48 months) (Group A), who underwent primary 15 years 13-29 years) B), redo surgery In Group A, performed a one-stage procedure using complete penile disassembly technique, while, B, done two-stage straightening lengthening penis, followed by urethral reconstruction. Penile were achieved tunica albuginea incision grafting. plate mobilized, transposed ventrally, tubularized augmented vascularized preputial skin flap where needed. urethra reconstructed either buccal mucosa graft genital flaps or tubularization flaps. Successful defined functional esthetically acceptable penis without complications. Results: follow-up 88 15-197 months). Satisfactory results 26/33 patients. Urethral fistula occurred 4/18 from A 3/15 B surgically repaired four months. Skin dehiscence eight patients, five three B. Recurrent curvature observed 2/18 required correction 2/15 mild did not need repair. Eleven filled out International Index Erectile Function reported satisfying erectile function, sexual desire, intercourse, overall satisfaction. Conclusion: Primary is challenging even experienced reconstructive urologists. Only radical approach can lead to all deformities provide successful outcome.