Epispadias

Epispadias is a congenital malformation of the external urethral orifice caused by a dorsal fusion defect of the urethra. Since congenital epispadias often co-occurs with bladder exstrophy, it can be embryologically considered part of bladder exstrophy. Male epispadias can be classified into the following three types: Glanular type: The external urethral orifice opens on the dorsal side of the wide and flat glans penis, and urinary incontinence is rare. Penile type: The external urethral orifice opens between the pubic symphysis and the coronal sulcus. The urethral opening is wide and trumpet-shaped, and the distal end of the external urethral orifice forms a groove extending to the glans penis. Penopubic type: The urethral orifice opens at the pubic symphysis. There is a complete urethral groove on the dorsal side of the penis extending to the glans penis, often accompanied by bladder exstrophy. Female epispadias can be classified into the following three types: Mild type (clitoral type): The urethral opening is wide. Moderate type (subpubic type): Most of the dorsal urethra is split. Severe type (complete type): The entire dorsal urethra is split and accompanied by urinary incontinence. This condition is more common in males, with a male-to-female ratio of approximately 3:1. The main symptoms include abnormal urethral opening position, genital malformation, and possible urinary incontinence.