title: Epispadias in boys with an intact prepuce.
abstract: OBJECTIVE
  To present an overview of the clinical presentation and pathological anatomy, and the results of surgical correction of 7 cases of epispadias with intact prepuce; a rare condition that has only occasionally been reported in literature.
  
  
  METHODS
  A retrospective search was performed in the surgical and diagnoses database between 1991 and 2011. Seven cases of epispadias with intact prepuce were identified. Five presented as a webbed and buried penis, 1 as phimosis and 1 with suspicion for congenital anomaly of the genitalia.
  
  
  RESULTS
  In 3 of 7 cases, epispadias was suspected or diagnosed at first presentation and could be surgically corrected in the first intervention. In the other 4 cases, epispadias was discovered during surgery, requiring an additional intervention to perform epispadias repair in 3 cases. One boy was diagnosed with glandular, 3 with coronal, 1 with shaft and 2 with penopubic epispadias. Epispadias repair was successful with regard to cosmesis and erectile function. Five patients developed normal continence after surgery, 1 after intensive urotherapy. An under average penile length was the main reported problem during follow-up.
  
  
  CONCLUSIONS
  In the diagnostic process for a concealed penis, the possibility of epispadias should be considered. If epispadias is suspected or confirmed, epispadias repair can occur in the first intervention, reducing the number of additional interventions. Epispadias with intact prepuce appears to have a better prognosis concerning urinary continence compared to classical epispadias.
authors.affiliation: Department of Pediatric Urology, University Children's Hospitals UMC Utrecht and AMC Amsterdam, The Netherlands. Electronic address: E.M.E.Bos@students.uu.nl.
authors.forename: E M E
authors.initials: EM
authors.lastname: Bos
authors.affiliation: Department of Pediatric Urology, University Children's Hospitals UMC Utrecht and AMC Amsterdam, The Netherlands. Electronic address: C.F.kuijper@amc.nl.
authors.forename: C F
authors.initials: CF
authors.lastname: Kuijper
authors.affiliation: Department of Pediatric Urology, University Children's Hospitals UMC Utrecht and AMC Amsterdam, The Netherlands. Electronic address: R.Chrzan@amc.nl.
authors.forename: R J
authors.initials: RJ
authors.lastname: Chrzan
authors.affiliation: Department of Pediatric Urology, University Children's Hospitals UMC Utrecht and AMC Amsterdam, The Netherlands. Electronic address: P.Dik@umcutrecht.nl.
authors.forename: P
authors.initials: P
authors.lastname: Dik
authors.affiliation: Department of Pediatric Urology, University Children's Hospitals UMC Utrecht and AMC Amsterdam, The Netherlands. Electronic address: A.J.Klijn@umcutrecht.nl.
authors.forename: A J
authors.initials: AJ
authors.lastname: Klijn
authors.affiliation: Department of Pediatric Urology, University Children's Hospitals UMC Utrecht and AMC Amsterdam, The Netherlands. Electronic address: T.P.V.M.deJong@umcutrecht.nl.
authors.forename: T P V M
authors.initials: TP
authors.lastname: de Jong
mesh_terms: D004842:Epispadias / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D013521:Urologic Surgical Procedures, Male / Q000379:methods*
keywords: Concealed; Epispadias; Intact; Pediatrics; Penis; Prepuce