EPISPADIAS.pptx

Epidemiology, how to classify it. Very common condition

1. Surgery 220 Topic: EPISPADIAS PRESENTED BY NANCY NYAMBE

2. Epispadias is a rare congenital malformation in which the opening of the urethra is on the dorsum of the penis. In epispadias there is a defect of the location of the opening of the urethra. The urethra does not fully develop into a full tube and the urine exists the body from and abnormal location.

3. In boys with epispadias, the urethra generally opens on the top or side of the penis rather than the tip. However it is possible for the urethra to be open along the entire length of the penis. In girls, normally, the opening is usually between the clitoris and the labia, but in epispadias, the opening may be on the lower abdominal area. Epispadias is more common in males than females. It can be associated with bladder exstrophy an uncommon birth defect in which the bladder develops outside the abdomen. The condition is usually diagnosed at birth, very mild cases may be missed at birth and diagnosed until later, if the child (usually female) leaks urine after toilet training.

4. Bladder exstrophy

5. Female epispadias

6. In boys, epispadias can result in the opening along the upper surface of the penis and it can happen in three areas; Penopubic; where the base of the pubic and abdominal wall come together. Penile; Which is in the middle of the penis Glanular ; on top of the glans penis

7. Penile epispadias

8. Epispadias mostly occurs in the 6 th week of gestation and be associated with improper development of the pubic bone. the position of the meatus is important because it predics the degree to which the bladder can store urine .

9. Causes of epispadias There is no known cause but there are some genetic cause such as a larger incidence of the condition in twins and in families.

10. Signs of epispadias Backward flow of urine into the kidney. Urinary incontinency Urgency and frequency of urination. Widened pubic bone. RISK FACTORS Gender( males are at high risk ) Race ( esp the Caucasians) Genetics, that is if a parent had it.

11. Management Surgical repair is recommended. For the childs recovery period, the clinician or the doctor may prescribe ; - Analgesia - Oral antibiotics broad spectrum Anti spasmodic\anti cholinergic drugs; these help to relieve bladder spasms.

12. Complications Stress incontinency; because the bladder neck can not close completely and the result is leakage of urine. Sexual problems;- infertility - difficult sexual intercourse because of the dorsal chordae and short, stubby penis. Psycho social stress Urinary tract infection.