Epispadias is usually diagnosed at birth based on the abnormal appearance of the urethra and genitalia. In some cases, epispadias may be detected during a prenatal ultrasound if the genital or urinary abnormalities are visible. The diagnostic process may include:

• Physical examination: After birth, a physical examination of the genitalia will confirm the diagnosis of epispadias based on the location of the urethral opening and the appearance of the external genitalia.
• Imaging tests: Additional imaging tests, such as an ultrasound or MRI, may be used to assess the extent of the condition and check for associated abnormalities in the bladder or urinary tract.
• Urodynamic studies: These tests measure how well the bladder stores and releases urine. Urodynamic studies are often used to evaluate bladder function and assess the risk of urinary incontinence.

Treatment for epispadias typically involves surgical correction to reposition the urethral opening and improve urinary control. Surgery is usually performed in infancy or early childhood to ensure normal development and improve the child’s quality of life. At Gertrude’s Children’s Hospital, we offer expert surgical care for children with epispadias. Treatment options include:

• Surgical repair:
  The primary treatment for epispadias is surgery to reconstruct the urethra and reposition the urethral opening to its correct location. The specific surgical approach depends on the severity of the condition and whether it is associated with bladder exstrophy. The goal of surgery is to:
  • Reposition the urethral opening: The surgeon will move the urethral opening to the tip of the penis in boys or to a more typical location in proximity to the clitoris in girls.
  • Reconstruct the genitalia: In boys, the surgery may also involve straightening the penis and reconstructing the shaft to improve both appearance and function. In girls, the clitoris may be reconstructed to restore a normal appearance.
  • Improve urinary continence: In some cases, additional procedures may be performed to strengthen the bladder and urethral muscles, allowing the child to control urination more effectively.
• Bladder exstrophy management:
  If epispadias is part of the bladder exstrophy-epispadias complex, additional surgeries may be required to close the bladder and reconstruct the abdominal wall. These surgeries are typically performed in stages, beginning in the first days or weeks of life.
• Urinary continence surgery:
  In children who experience urinary incontinence after initial surgery, further surgical procedures may be needed to improve bladder control. This may include bladder neck reconstruction or the creation of a catheterizable stoma (an opening in the abdomen to allow for catheterization).
• Postoperative care and follow-up:
  After surgery, children with epispadias require regular follow-up care to monitor urinary function, bladder health, and genital development. Additional procedures or treatments may be needed as the child grows.

At Gertrude’s Children’s Hospital, we are committed to providing the best possible care for children with Epispadias in Children. Here’s why families trust us:

If your child has been diagnosed with epispadias, Gertrude’s Children’s Hospital is here to provide expert care. Our pediatric urology specialists will work with you to develop a personalized treatment plan to ensure your child’s health and well-being.