Epispadias

A birth defect due to malformation of the URETHRA in which the urethral opening is above its normal location. In the male, the malformed urethra generally opens on the top or the side of the PENIS, but the urethra can also be open the entire length of the penis. In the female, the malformed urethral opening is often between the CLITORIS and the labia, or in the ABDOMEN.

Also Known As:

Networked: 165 relevant articles (11 outcomes, 6 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Bladder Exstrophy (Exstrophy, Bladder)
2.	Urinary Incontinence
3.	Fistula
4.	Wounds and Injuries (Trauma)
5.	Hypospadias

Experts

1.	Gearhart, John P: 12 articles (05/2021 - 03/2003)
2.	Kajbafzadeh, Abdol-Mohammad: 9 articles (01/2022 - 05/2007)
3.	Sabetkish, Nastaran: 5 articles (01/2022 - 02/2017)
4.	Reutter, Heiko: 5 articles (09/2012 - 09/2008)
5.	Gearhart, J P: 5 articles (04/2008 - 05/2001)
6.	Eftekharzadeh, Sahar: 4 articles (01/2022 - 02/2017)
7.	Sabetkish, Shabnam: 4 articles (01/2022 - 02/2017)
8.	Rösch, Wolfgang H: 4 articles (11/2011 - 09/2008)
9.	Bivalacqua, Trinity J: 3 articles (03/2021 - 10/2010)
10.	Burnett, Arthur L: 3 articles (03/2021 - 12/2019)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Epispadias:

1.	Fibrin Tissue Adhesive (Fibrin Sealant)IBA 08/01/2011 - "Single-donor fibrin sealant for repair of urethrocutaneous fistulae following multiple hypospadias and epispadias repairs." 08/01/2011 - "To evaluate the efficacy of fibrin sealant for repair of urethrocutaneous fistula after multiple failed hypospadias and epispadias surgeries. " 08/01/2011 - "Single-donor fibrin glue could be a useful adjunct to surgical management of patients after multiple failed attempts at hypospadias or epispadias fistula repair. " 01/01/2023 - "Differences in age at repair, primary EEC diagnosis, prior epispadias repair, pre-repair testosterone, fibrin sealant utilization, closure layers, stent removal time, and bladder capacity at repair were not statistically significant (P>.05) CONCLUSION: Our expanded evaluation indicates that utilization of the tunica vaginalis as an adjunct to epispadias repair may provide durable protection against fistula development in EEC patients who have undergone prior epispadias repair and in primary repair of patients with isolated epispadias."
2.	Durapatite (Hydroxylapatite)IBA 02/01/2017 - "The aim of this study was to evaluate the efficacy of the endoscopic injection of calcium hydroxyapatite (CaHA) into the bladder neck (BN) region of patients with urinary incontinence and bladder exstrophy-epispadias complex (BEEC). " 02/01/2017 - "Comparing the bulking effect of calcium hydroxyapatite and Deflux injection into the bladder neck for improvement of urinary incontinence in bladder exstrophy-epispadias complex."
3.	CollagenIBA 02/01/1996 - "Exstrophy/epispadias patients have the best outcome from collagen treatment. " 08/01/1996 - "Patients with adequate capacity and compliant neurogenic bladders, and those with the exstrophy-epispadias complex and failed bladder neck plasty seem to be optimal candidates for collagen injection." 04/01/1995 - "Five more children with exstrophy-epispadias complex (aged 1-3 years) underwent periurethral collagen injection to stimulate bladder enhancement and allow subsequent bladder neck reconstruction. " 08/01/1993 - "We injected endoscopically 0.75 to 2.5 cc of cross-linked bovine collagen at the 3, 9 and 12 o'clock positions of the urethra or bladder neck of 9 children with epispadias and 7 with exstrophy. " 03/01/1993 - "Female genito-urethroplasty and submucosal periurethral collagen injection as adjunctive procedures for continence in the exstrophy-epispadias complex. "
4.	Testosterone (Sustanon)FDA Link 05/01/2001 - "Epispadias repair can usually be performed at the same time and is facilitated by prior testosterone administration. " 01/01/2023 - "Differences in age at repair, primary EEC diagnosis, prior epispadias repair, pre-repair testosterone, fibrin sealant utilization, closure layers, stent removal time, and bladder capacity at repair were not statistically significant (P>.05) CONCLUSION: Our expanded evaluation indicates that utilization of the tunica vaginalis as an adjunct to epispadias repair may provide durable protection against fistula development in EEC patients who have undergone prior epispadias repair and in primary repair of patients with isolated epispadias."
5.	baysilon (polydimethylsiloxane)IBA 10/01/2006 - "To present our experience with the use of injectable polydimethylsiloxane (Macroplastique, Uroplasty, Minneapolis, MI, USA) for treating incontinence in children with the exstrophy-epispadias complex (EEC), as incontinence continues to be a challenging problem in such children, and although the primary management of EEC has developed over the last few decades, with early closure and reconstruction of the penis, achieving satisfactory continence status remains elusive. " 10/01/2006 - "Injectable polydimethylsiloxane for treating incontinence in children with the exstrophy-epispadias complex: long-term results." 02/01/1998 - "To evaluate the efficacy of the endoscopic insertion of polydimethylsiloxane particles (Macroplastique, Uroplasty Inc) (MPQ) into the posterior urethral region of boys with urinary incontinence and primary epispadias. " 10/01/2006 - "Patients with epispadias are more likely to benefit from an injection with Macroplastique than those with bladder exstrophy. " 10/01/2006 - "We retrospectively reviewed the hospital records of 52 patients (41 boys and 11 girls, mean age at first injection 6.6 years, range 3.6-16.7) with EEC who had injections with Macroplastique between January 1991 and February 2004; 34 had bladder exstrophy and 18 primary epispadias. "
6.	AntigensIBA 05/01/2012 - "This is the first study to our knowledge to characterize the urothelium from infants with bladder exstrophy-epispadias complex for the expression of urothelial differentiation associated antigens. "
7.	PlasticsIBA 06/01/1984 - "[Plastic repair of epispadias with incontinence]." 11/01/1979 - "[Plastic repair of the urinary channel in epispadias]." 01/01/1869 - "On Fission and Extroversion of the Bladder with Epispadias; with the results of eight cases treated by Plastic Operations." 11/01/1964 - "[LARGE URETHRAL CALCULUS AFTER PLASTIC REPAIR OF TOTAL EPISPADIAS]."
8.	Proteins (Proteins, Gene)FDA Link 07/01/2010 - "The Cyr61 gene exhibited the highest response to FLU in rat fetal testis, and we suggested it a promising candidate gene for epispadias in humans, because its protein product promotes proliferation, migration, and adhesion of endothelial cells and fibroblasts. " 05/01/2012 - "We characterize the urothelium from patients with classic bladder exstrophy-epispadias complex for the expression of proteins associated with urothelial differentiation, and discuss a potential impact of urothelial phenotype on the structural and functional properties of the bladder template following bladder closure. " 09/15/2012 - "Murine expression and mutation analyses of the prostate androgen-regulated mucin-like protein 1 (Parm1) gene, a candidate for human epispadias."
9.	Glutaral (Glutaraldehyde)IBA 08/01/1993 - "Glutaraldehyde cross-linked bovine collagen in exstrophy/epispadias complex." 04/01/1995 - "Over the same period, 25 patients aged between 2 and 14 years (nine with neuropathic bladder and 16 with exstrophy-epispadias complex who were still incontinent after bladder neck reconstruction) had periurethral or pericervical glutaraldehyde cross-linked bovine collagen injection for UI. " 08/01/1995 - "Submucosal bladder neck injections of glutaraldehyde cross-linked bovine collagen for the treatment of urinary incontinence in patients with the exstrophy/epispadias complex."
10.	SolutionsIBA 05/01/2002 - "A novel solution for the short neourethra in Mitchell epispadias repair." 06/01/1999 - "Following unsuccessful or unsatisfactory primary treatment in patients with the epispadias/exstrophy complex, the options for a surgical solution to preserve the upper urinary tract, to achieve complete continence, and to reconstruct the external and female internal genitalia are limited. "

Therapies and Procedures

1.	Osteotomy 07/01/1999 - "We believe that in patients with failed exstrophy and epispadias repair, APD seems to be a predictive criterion for continence, and results of the reconstructive surgery with osteotomy should be improved by distraction of the anterior segment of the pelvic ring." 08/01/2015 - "The present study is a retrospective review of patients that underwent pelvic osteotomies with spica casting at the time of CPRE or proximal epispadias repair from November 2006 to March 2013. " 11/01/2023 - "A prospectively maintained institutional approved exstrophy-epispadias complex database of 1487 patients was reviewed for patients with CBE who had undergone closure without osteotomy nor immobilization. " 01/01/2023 - "A prospectively maintained institutional exstrophy-epispadias complex database of 1415 patients was reviewed for patients with CBE who had undergone closure with available immobilization and osteotomy data. " 10/01/2022 - "A prospectively maintained, IRB-approved database of 1401 exstrophy-epispadias patients was reviewed for patients with CBE or CE after primary closure and pelvic osteotomy performed at a single institution from 1975 to 2021. "
2.	Urinary Diversion (Ileal Conduit) 11/01/1992 - "This series supports the efficacy of CUR as an alternative procedure to traditional forms of urinary diversion in the management of selected patients with exstrophy/epispadias complex." 05/01/2011 - "Continent urinary diversion in the epispadias-exstrophy complex." 09/01/2008 - "Of the 21 patients, 17 had undergone single-stage reconstruction, 1 had undergone a staged approach, 2 had primarily undergone urinary diversion, and 1 had only undergone external genital reconstruction of epispadias. " 03/01/2003 - "Continent urinary diversion and the exstrophy-epispadias complex." 12/01/2000 - "Urinary diversion in children with mainly exstrophy and epispadias: alternative to primary bladder closure."
3.	Cystectomy 10/01/2021 - "In adult EEC patients, cystectomy + MAINZ Pouch II and epispadias repair is safe and effective. " 10/01/2021 - "Out of which, 20 underwent cystectomy + MAINZ Pouch II with epispadias repair as a staged procedure. " 10/01/2021 - "To evaluate surgical outcomes and renal functions after cystectomy + MAINZ Pouch II and epispadias repair as a staged procedure in adult patients with exstrophy epispadias complex (EEC). " 10/01/2021 - "Outcomes of Cystectomy with MAINZ Pouch II and Epispadias Repair in Exstrophy Epispadias Complex in Adults: A Single-centre Experience from Pakistan." 06/01/2018 - "A prospectively maintained database of 1298 patients with exstrophy-epispadias complex was reviewed for patients who underwent cystectomy between 1970 and 2015 at the authors' institution. "
4.	Transplantation 01/01/1924 - "Case of Transplantation of the Rectus for Incontinence due to Epispadias." 12/01/1895 - "I. Operative Treatment of Epispadias by Transplantation of the Urethra." 11/01/2011 - "The 4-year outcomes demonstrate that autologous myoblast transplantation for urinary incontinence in children with bladder exstrophy-epispadias complex is relatively reliable, reproducible, safe and effective with minimal morbidity. " 11/01/2011 - "Children with bladder exstrophy-epispadias complex undergoing endourethral autologous myoblast transplantation to treat urinary incontinence were evaluated at 4 years of followup regarding the safety, efficacy and durability of the procedure, and health related quality of life. " 11/01/2011 - "Safety, efficacy and health related quality of life of autologous myoblast transplantation for treatment of urinary incontinence in children with bladder exstrophy-epispadias complex."
5.	Stents 12/01/2011 - "A urethral stent was used only for patients with isolated epispadias. " 01/01/2023 - "Differences in age at repair, primary EEC diagnosis, prior epispadias repair, pre-repair testosterone, fibrin sealant utilization, closure layers, stent removal time, and bladder capacity at repair were not statistically significant (P>.05) CONCLUSION: Our expanded evaluation indicates that utilization of the tunica vaginalis as an adjunct to epispadias repair may provide durable protection against fistula development in EEC patients who have undergone prior epispadias repair and in primary repair of patients with isolated epispadias."