What is epispadias?

Epispadias is a very rare condition that affects the urethra, the tube-like channel from which urine exits the body. It is a congenital condition, this means that a baby is born with the condition.

In children with epispadias, the urethra doesn't develop correctly, and the opening of the urethra is not where it is supposed to be. In boys, the opening generally is found on top of the penis instead of at the tip, and the penis looks abnormal. In girls, the opening may be near the clitoris or in the belly. The condition can range from mild to very severe, depending on where the opening is located.

Babies born with epispadias often have other bladder problems. It is often associated with a condition called bladder exstrophy. In this rare condition, the bladder forms outside of the abdominal wall.

Epispadias is often confused with an abnormal foreskin, in which the foreskin gives the appearance of the urethral opening located abnormally high position. This is more common than true epispadias.

What are the signs and symptoms of epispadias?

Epispadias is often diagnosed at birth when doctors notice the opening of the urethra is not in the right location. In mild cases, most often in girls, it may not be diagnosed until parents notice leaking urine after toilet training.

Other symptoms in boys may include:

  • A penis that is wide and short and may curve upward
  • A deep groove between the opening of the urethra and the tip of the penis
  • Leaking urine (incontinence)
  • Wider than normal pubic bones

Symptoms in girls can include:

  • Clitoris or labia that are abnormally shaped
  • Leaking urine (incontinence)
  • Wider than normal pubic bones

What causes epispadias?

Doctors don’t know the exact cause of epispadias, but it develops during pregnancy.

How is epispadias treated?

In most cases, babies born with epispadias will need surgery shortly after birth. Some babies with a mild form of epispadias may not need surgery.

Surgery for boys may include improving the look and function of the penis and improving bladder control. Surgery for girls is usually less involved but may consist of bringing two parts of the clitoris together or reconstructing the vaginal opening if it is narrow.

The Division of Urology at Arkansas Children’s is experienced in treating all forms of epispadias and will work with you to come up with the best treatment plan for your child.