Epispadial repair

1. EPISPADIAS REPAIR
Presented by----
Mrs. Usha Rani Kandula,
MSc.Nursing, Assistant professor,
Department of Adult Health Nursing,
College of Health Sciences,
Arsi University, Asella, Ethiopia.

2. DEFINITION
 Correction of a congenital absence of the
dorsal wall of the urethra proximal to the
glans penis.

4. URETHRAL MEATUS OPENS
 -The urethral meatus opens on the dorsal
aspect of the penis.
 -This deformity at the abdomino penile
junction
 -Associated with deformities of the bladder
and urinary sphincter.

5. NO CIRCUMCISION
 -Repair is necessary.
 -Circumcision should not be performed on
infants with epispadias
 -in order to preserve skin useful in correcting
the deformity.

6. FIRST STAGE REPAIR
 -The procedure may be staged;
 -The first stage involves the rotation of the
foreskin to cover the defect created by
mobilizing the distal urethra.

7. SECOND STAGE REPAIR
 -A second stage addresses the creation of the
distal urethra and meatus.
 -If defective, the bladder and prostatic urethra
are repaired.

8. PROCEDURE
 -When epi-spadias occurs in the distal penis,
the tissues are mobilized and sutured over the
defect.
 -The urethral meatus is opened at the tip of
the glans penis.

9. CREATING SUPRA PUBIC
INCISION
 -A supra pubic incision is made to expose the
prostatic urethra.
 -Redundant tissue of the prostatic urethra is
excised.

10. SUTURING WITH CATGUT
 -Absorbable sutures,
 e.g., catgut approximate the prostatic urethra
and vesical neck over a probe or catheter,
 -recreating the continence mechanism.

11. PLACEMENT OF SUPRAPUBIC
CYSTOSTOMY TUBE
 -A suprapubic cystostomy tube is placed to
provide temporary urinary diversion.
 -The skin is closed.

12.  -For Preparation of the Patient, Skin
Preparation, Draping, Equipment, and
Instrumentation, Supplies, and Special Notes,
see Hypospadias Repair,.

13. SUPPLIES
 Add suprapubic cystostomy catheter,
 e.g., Pezzer, Malecot.
 Thanking you.