70 cases of epispadias are reviewed (56 boys, 14 girls). 11 boys with continent epispadias were treated, with perineal urethrostomy, by a technique similar to the Duplay technique for hypospadias: 4 good results, 4 fistulae which needed a second operation, 2 urethroceles, one complete failure. 30 cases of incontinent epispadias (8 girls and 22 boys) were operated on with a technique similar to the one described by Young. Some details are important: (1)Not to operate too young: 9–11 years of age because it is a painful operation and it is important to have a co-operative child the months following the operation; frequent micturations, each micturation done in several times. (2) To make a new posterior urethra of very small caliber. (3) To fill the empty space between the pubis and the reconstructed urethra with muscles (rectus of the abdomen or gracilis of the thigh). The results are: 2 patients without follow up; 6 failures; 4 mediocre results; 18 good results with a follow up from 1.5 to 13 years. The upper urinary tract stays normal.

Keywords:
Urinary incontinence, Anomaly of the urethra, Pediatric urology
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© 1972 S. Karger AG, Basel
1972
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