Identify this abnormality:
- An epispadias is a rare type of congenital malformation in which the urethra opens on the dorsum (the upper aspect) of the penis. It is often part of the condition termed Epispadias-exstrophy of the bladder. Epispadias is a mild form of bladder exstrophy, and in severe cases, exstrophy and epispadias coexist.
- The extent of the defect can vary from a mild glandular defect to complete defects as are observed in bladder exstrophy, diastasis of the pubic bones, or both.
- In glandular epispadias, the urethra opens on the dorsal aspect of the glans, which is broad and flattened.
- In the penile type, the urethral meatus, which is broad and gaping, is located between the pubic symphysis and the coronal sulcus. A distal groove usually extends from the meatus through the splayed glans.
- The penopubic type has the urethral opening at the penopubic junction, and the entire penis has a distal dorsal groove extending through the glans.
- All types of epispadias are associated with varying degrees of dorsal chordee.
- Females with epispadias have a bifid clitoris and separation of the labia.
- Male to female ratio of epispadias is 3: 1.
- Incontinence due to maldevelopment of urinary sphincters is commonly associated with most epispadias except for the glandular type.
- Other associated anomaly is pubic diastasis as in exstrophy.
- Surgery is required to correct the incontinence, remove the chordee to straighten the penis, and extend the urethra out onto the glans penis.