Results of complete penile disassembly for epispadias repair in 42 patients.
OBJECTIVE
We evaluated the Mitchell complete penile disassembly technique for epispadias repair.


METHODS
A total of 42 males 1 month to 22 years old presented for repair of epispadias between 1998 and 2002. Cases were divided into 2 groups. Group 1 included 29 cases of complete epispadias as a component of bladder exstrophy, 8 with previous continent urinary diversion. Group 2 included 13 cases of epispadias alone (10 primary and 3 secondary). Of the 29 patients in group 1, 21 underwent complete penile disassembly as part of 1-stage primary closure of bladder exstrophy.


RESULTS
Mean followup was 37.5 months (range 6 to 52). Ischemic changes at the glans penis were observed in 5 cases during our initial experience. Ventral orthotopic meatus was observed in all 42 patients, conical glans in 40 (95.2%), straight shaft in 34 (81%) and urethral fistula in 1 (2.4%). There were no cases of dehiscence, meatal stenosis or urethral stricture. Erectile function was preserved in all patients.


CONCLUSIONS
Complete penile disassembly is a safe procedure that can provide normalization of the urethra and penis together with satisfactory cosmetic and functional outcome.
Hammouda
Hisham M
HM
Pediatric Urology Division, Urology Department, Assiut Univeraity, Assiut, Egypt.
D000293:Adolescent; D000328:Adult; D001746:Bladder Exstrophy / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004842:Epispadias / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D010413:Penis / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D012086:Reoperation; D016896:Treatment Outcome; D016476:Urinary Reservoirs, Continent