Penile skin reconstruction in epispadias repair in boys with bladder exstrophy: anatomical and cosmetic outcomes
Received: 2026-10-05
Published: 2026-03-30
Abstract
Objective: To assess the anatomical and cosmetic outcomes of an original method of penile skin reconstruction during epispadias repair in boys with bladder exstrophy.
Materials and Methods: Epispadias repair was performed in 41 boys of the main groups: 22 with staged and 19 with single-stage correction at the National Children's Medical Center. When skin was deficient, the defect was closed with the child's own transposed flaps and the cranial scrotal transposition was corrected (patent No. IAP 8300); a small penis received preoperative androgen priming. Penile length, dorsal curvature, skin defect closure and complications were assessed. Wilcoxon, Mann-Whitney, chi-square and Fisher's exact tests were used.
Results: Penile length increased from 26.30 +/- 2.97 to 32.24 +/- 2.61 mm in the first group (p < 0.02) and from 27.11 +/- 2.14 to 32.22 +/- 2.30 mm in the second (p < 0.008). Dorsal curvature fell from 28.75 deg +/- 5.15 to 1.75 deg +/- 1.75 (p < 0.007). The skin defect was closed primarily in 27.3% of boys. Complications in the group where the method was used were 13.6% versus 36.8%.
Conclusions: The method closes the skin defect in one stage, lengthens and straightens the penis and lowers the rate of wound complications. It is autologous and reproducible in pediatric urology units.
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List of references
-
Агзамходжаев С.Т., Абдуллаев З.Б., Алиев Т.Г., Пелих К.И., Каганцов И.М. Экстрофия мочевого пузыря у детей: эволюция диагностики и современные тенденции хирургического лечения. Урологические ведомости. 2024;14(4):449–459.
-
Morrill CC, Haffar A, Harris TGW, Crigger C, Gearhart JP. Current management of classic bladder exstrophy in the modern era. African Journal of Urology. 2023;29(1):27.
-
Hammouda HM, Abdelgawad AM, Shahat AA. Penile reconstruction after complete bladder exstrophy repair. Journal of Pediatric Urology. 2024;20(3):407.e1–407.e4.
-
Bencic M, Bizic M, Joksic I, Stojanovic B, Djordjevic ML. Isolated male epispadias repair: long-term outcomes. Life. 2024;14(4):446.
-
Deng F, Fu W, Liu G, Sun L. A novel modified penile disassembly procedure for isolated male epispadias repair: preliminary outcomes. Frontiers in Pediatrics. 2024;12:1371576.
-
Fainberg JS, Gamal A, Hanna MK. Outcome of penile lengthening of adolescents and young adults born with bladder exstrophy and epispadias. Journal of Pediatric Urology. 2021;17(3):331.e1–331.e6.
-
Sembiring G, Sigumonrong Y. Efficacy of preoperative testosterone therapy in hypospadias: a systematic review and meta-analysis. Annals of Pediatric Surgery. 2021;17:56.
-
Godlewski K, Kell M, Long C. Review of testosterone/androgen use in pediatric urology. Current Treatment Options in Pediatrics. 2025;11(1):22.
-
Sinatti C, Waterschoot M, Roth J, Van Laecke E, Hoebeke P, Spinoit AF. Long-term sexual outcomes in patients with exstrophy-epispadias complex. International Journal of Impotence Research. 2021;33(2):164–169.
-
Spinoit A-F, Waterschoot M, Sinatti C, et al. Fertility and sexuality issues in congenital lifelong urology patients: male aspects. World Journal of Urology. 2021;39(4):1013–1019.
-
Harris KT, Namdarian B, Gearhart JP, Wood D. Long term outcomes in classic bladder exstrophy: the adult picture. Journal of Pediatric Urology. 2024;20(2):157–164.
-
The complete primary repair of bladder exstrophy: refinements through the Multi-Institutional Bladder Exstrophy Consortium (MIBEC). Journal of Pediatric Urology. 2022.
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