Epispadias

As epispadias (from gr ἐπί: about σπαδόν: column ) or upper urethra cleavage ( urethral fissure superior) refers to a congenital malformation in which the urethra usually opens at the dorsal penis. The contrary, the opening of the urethra at the base of the penis is referred to as hypospadias.

Cause

The reason is a partial developmental disorder of the cloacal membrane. However, this is less pronounced than in the case of bladder exstrophy.

Findings and diagnostic

The epispadias can be seen with the naked eye, it is a so-called " visual diagnosis ". Depending on the location of the urethral opening can the disease be divided gradually. For this purpose, the attributes

• Glandis ( urinary meatus on the glans penis, but dorsal to the loco Typico )
• Coronaria ( in Corona glandis )
• Penis ( penile shaft ),
• Pubis ( above the penis ) and
• Totalis (open bubble - see also bladder exstrophy )

Be used.

Other abnormalities such as the Dorsalkurvatur of the penis or a dorsally divided prepuce may be associated with epispadias occur. With a Epispadia pubis typically also urinary incontinence is connected, because even the bladder sphincter (and possibly also the symphysis ) not grown together, are so divided.

In the presence of epispadias are complementary diagnostic sonography and excretory recommended as a basic diagnostic.

Clinical significance

As a rule, stand here, in contrast to the cosmetic aspects of hypospadias less important, but rather the functional such as incontinence ( in high level ), pain during erection and a impotentia coeundi due to a shortening of the pars pendulans of the penis. Also, mental disorders are often associated with it.

Therapy

To correct the malformation are operative penile and Harnröhrenplasiken in the 1st - 4th Age possible. In the case of incontinence, a reconstruction of the sphincter of the bladder is attempted in 3 years; this does not work, so it requires other forms of urinary diversion.