Epispadias: Treatment

Treatment is surgical in all cases. The main goal of surgery for the exstrophy is closure of the abdominal wall and formation of a bladder, if one can be salvaged. The spacing or width of the pelvis can can be abnormal in cases of exstrophy, called diastasis, and surgery to rotate and join the halves of the pelvis often takes place in infancy.

Epispadias is corrected with techniques like the Cantwell-Ransey approach to close the urethra and the Kelly procedure. The main difference in epispadias is that the penis is very wide, and very short. The erectile chambers or cavernosa in the epispadic penis are separated and are not connected to each other, which is not the case in the typical penis or hypospadic penis. The aim of the Kelly procedure is to bring the portions of the penis anchored to the pelvis together to conserve and liberate as much length as possible so the proportions of the penis are more typical. Correction of chordee follows standard techniques practiced in hypospadias repair.