Results of Epispadias Repair Using the Modified Cantwell-Ransley Technique

• Published in: Urology (Ridgewood, N.J.) Vol. 99; pp. 221 - 224
• Main Authors: Bar-Yosef, Yuval, Sofer, Mario, Ekstein, Margaret P, Binyamini, Yosef, Ben-Chaim, Jacob
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2017
• Subjects: Child, Preschool; Epispadias - surgery; Follow-Up Studies; Forecasting; Humans; Infant; Male; Penis - surgery; Reconstructive Surgical Procedures - methods; Retrospective Studies; Surgical Flaps; Time Factors; Treatment Outcome; Urethra - surgery; Urologic Surgical Procedures, Male - methods; Urology
• DOI: 10.1016/j.urology.2016.07.018
• ISSN: 0090-4295

Objective To evaluate our results of epispadias repair with a modified Cantwell-Ransley (MCR) technique. Methods A retrospective Institutional Review Board-approved chart review of all patients who underwent an MCR epispadias repair was conducted between 1998 and 2015. Procedures were performed at birth or after the age of 8 months as part of the modern staged repair of exstrophy-epispadias complex (EEC) in patients with bladder exstrophy treated since birth, at presentation for older patients, and after the age of 6 months in isolated epispadias patients. Twenty-two children underwent MCR epispadias repair in our institute during the study period. Sixteen of them had EEC and 6 had isolated epispadias. Four patients underwent exstrophy and epispadias repair at the same session. Twelve children underwent epispadias repair as a second stage of modern staged repair at a mean age of 21 months (range 8-60). The procedures involved dissection of the corporeal bodies and urethral plate from the penile base to the tip of the penile glans. Results After a mean follow-up of 6.9 years (range 0.5-18), there were no complications in the isolated epispadias group and 4 complications in the bladder exstrophy group: urethrocutaneous fistula ( n  = 1), residual dorsal curvature ( n  = 1), and excess of penile skin ( n  = 2). The meatal location was orthotopic in all cases. All of the complications were successfully addressed in a single subsequent surgical session. Conclusion MCR technique continues to be a reliable, reproducible option for epispadias repair in EEC patients and in cases of isolated epispadias.