Overview of Epispadias

Epispadias is a congenital abnormality (present at birth) in which the urinary tube (urethra) develops on the wrong side. The skin that covers the lower abdominal part does not develop completely and the bladder is exposed on the child’s lower abdomen.

Epispadias is also known as bladder exstrophy, ‘Exstrophy’ meaning ‘turning inside out’. 

As the urethra does not develop properly, urine comes from an abnormal site of the bladder. In male epispadias, the urethral opening is either at the top or any side of the penis other than the tip. In female epispadias, the opening of the urethra is higher or it opens next to the bladder.  


It is a very rare condition i.e. 1 in 30,000 births and found more in males as compared to females.

Doctors Treating Epispadias

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Signs and Symptoms of Epispadias

  • Abnormal urethral opening (from where urine comes)
  • Reflux nephropathy (back flow of urine towards the kidney)
  • Short, curved, and widened penis
  • Urinary tract infections
  • Widened pubic bones
  • Urinary incontinence (unable to control urine)

Types of Epispadias

Causes of Epispadias

The exact causes of epispadias are not known. It is believed that it may happen due to the incomplete development of pubic bones.


Risk Factors of Epispadias

What Complications Epispadias Can Produce?

A child having epispadias cannot control his urine even after surgery (rare case). A child may experience long-term kidney and urinary tract damage. Urinary tract infections are at increased risk to develop. There might be a chance of infertility in epispadias (unable to produce offspring).

Talk to a pediatrician to discuss benefits and complications of treatment before taking the risk of surgery.





It can be diagnosed before birth by prenatal ultrasound, during the 11th gestation week. However, it becomes clear right after birth usually in males while later in females when they develop infections or urine control problems. Depending on the condition of the Intravenous, a pyelogram (x-ray of ureters, bladder, and kidneys), CT scan, and MRI scan are recommended.

Treatment of Epispadias | When to Consult a Doctor

Your doctor (urologist) will devise a treatment plan depending on your condition.

Treatment involves surgery in which the bladder is put in the proper place (inside the abdomen) and closed the belly. Surgery can be done at three different stages;

  • Stage 1: performed when the baby is 48 hours old.
  • Stage 2: performed before 6 months old baby. 
  • Stage 3: performed at the age of 4 or 5 years when the bladder becomes large enough. At this stage, the urinary tract is realigned along with the bladder.

Risks Associated with Epispadias Surgery

There is a high risk of infection after surgery. The wound may not properly heal and opens up again which will change the bladder position. In this case, another operation is needed. There is an increased risk of kidney damage that sometimes turns into hydronephrosis (swollen kidney).