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Bizic et al. Plast Aesthet Res 2022;9:14 Plastic and
DOI: 10.20517/2347-9264.2021.102
Aesthetic Research

Original Article Open Access

Epispadias: recent techniques

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Marta R. Bizic , Borko Stojanovic , Marko Bencic , Ivana Joksic , Miroslav L. Djordjevic 1,2,4
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Department of Urology, University Children’s Hospital, Faculty of Medicine, University of Belgrade, Belgrade 11000, Serbia.
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Department of Urology, Belgrade Center for Urogenital Reconstructive Surgery, Belgrade 11000, Serbia.
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Department of Genetics, Gynecology and Obstetrics Clinic “Narodni Front”, Belgrade 11000, Serbia.
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Department of Urology, Icahn School for Medicine at Mount Sinai, New York, NY 10075, USA.
Correspondence to: Dr. Marta R. Bizic, Department of Urology, University Children’s Hospital, Faculty of Medicine, University of
Belgrade, Tirosva 10, Belgrade 11000, Serbia. E-mail: martabizic@uromiros.com
How to cite this article: Bizic MR, Stojanovic B, Bencic M, Joksic I, Djordjevic ML. Epispadias: recent techniques. Plast Aesthet Res
2022;9:14. https://dx.doi.org/10.20517/2347-9264.2021.102
Received: 15 Sep 2021 First Decision: 13 Dec 2021 Revised: 15 Dec 2021 Accepted: 17 Jan 2022 Published: 16 Feb 2022
Academic Editors: Stan Monstrey, Gennaro Selvaggi Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen

Abstract
Aim: This paper presents the latest surgical approaches for epispadias treatment in the pediatric population, as
well as those for adolescent and adult populations after initial failed repair in childhood.

Methods: The retrospective study was conducted between March 2005 and May 2020 and included 18 patients
with the mean age of 21 months (range 11-48 months) (Group A), who underwent primary epispadias repair and 15
patients with the mean age of 18 years (range 13-29 years) (Group B), who underwent redo surgery after failed
epispadias repair in childhood. In Group A, the surgery was performed as a one-stage procedure using complete
penile disassembly technique, while, in Group B, the surgery was done as a two-stage procedure and included
complete straightening and lengthening of the penis, followed by urethral reconstruction. Penile straightening and
lengthening were achieved by tunica albuginea incision and grafting. In Group A, the urethral plate was mobilized,
transposed ventrally, and tubularized and augmented with vascularized preputial skin flap where needed. In Group
B, the urethra was reconstructed either using the buccal mucosa graft and genital skin flaps or with tubularization
of genital skin flaps. Successful treatment was defined as a functional and esthetically acceptable penis without
complications.

Results: The mean follow-up was 88 months (range 15-197 months). Satisfactory results were achieved in 26/33
patients. Urethral fistula occurred in 4/18 patients from Group A and in 3/15 patients in Group B and was surgically
repaired after four months. Skin dehiscence occurred in eight patients, five from Group A and three from Group B.
Recurrent penile curvature was observed in 2/18 patients from Group A and required surgical correction and in

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0
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