Epispadias | Symptoms & Causes
What causes epispadias?
The exact cause of epispadias is unknown. Popular theories suggest that a structure known as the cloacal membrane might not develop normally. This may prevent appropriate tissue development, ingrowth, and the joining together of the urethra in the midline.
Epispadias | Diagnosis & Treatments
How is epispadias diagnosed?
Epispadias is typically diagnosed immediately after birth during the initial physical examination. However, especially in females with epispadias, the diagnosis may not be made until challenges related to toilet training prompts a thorough genitourinary physical exam.
How is epispadias treated?
The primary goal of treatment for epispadias is to:
- Develop adequate bladder function and promote urinary continence
- Provide acceptable appearance and function of the external genitalia
- Ensure that your child has a typical and normal childhood
Epispadias repair typically occurs when a child is 6 to 12 months old. The type of surgical repair depends on the severity of the anomaly. If epispadias is mild, surgery may only involve the urethra and external genitalia. If epispadias is more severe, surgery may also involve the bladder neck and pelvic bones.
At Boston Children’s, we also evaluate many older children who have persistent urinary incontinence. We provide individualized care based on patients’ unique anatomies and individual needs. Many patients experience improvements in incontinence over time and with medications and physical therapy. In select patients, additional surgeries, such as bladder neck reconstruction, may be required to help achieve continence.
How we care for epispadias
The experts in our Bladder Exstrophy Program provide exceptional pediatric care to children with epispadias and their families. Our team includes physician specialists in urology, nephrology, orthopedic surgery, anesthesiology, radiology, and nuclear medicine, as well as nurses, social workers, and child life specialists who will care and support you and your child at every step, from diagnosis through treatment, and even after your child returns home.
We offer a variety of resources for families, including access to the Fetal Care and Surgery Center (FCSC). The FCSC provides support through prenatal counseling, treatment, and follow-up for families with a confirmed or suspected fetal congenital anomaly. In addition, medical staff, social workers, child life specialists, and spiritual care services are available to support expectant parents.
