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Epispadial repair
The document discusses the procedure for epispadias repair, which involves correcting a congenital absence of the dorsal wall of the urethra proximal to the glans penis in multiple stages. The first stage involves rotating the foreskin to cover the defect and mobilizing the distal urethra, while the second stage addresses creating the distal urethra and meatus, as well as repairing any defects in the bladder or prostatic urethra. The procedure may also include making a supra pubic incision to expose the prostatic urethra and suturing it with absorbable sutures to recreate the contin
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Epispadial repair
- 1. EPISPADIAS REPAIR Presented by---- Mrs.Usha Rani Kandula, MSc.Nursing, Assistant professor, Department of Adult Health Nursing, College of Health Sciences, Arsi University, Asella, Ethiopia.
- 2. DEFINITION Correction ofa congenital absence of the dorsal wall of the urethra proximal to the glans penis.
- 4. URETHRAL MEATUS OPENS -The urethral meatus opens on the dorsal aspect of the penis. -This deformity at the abdomino penile junction -Associated with deformities of the bladder and urinary sphincter.
- 5. NO CIRCUMCISION -Repairis necessary. -Circumcision should not be performed on infants with epispadias -in order to preserve skin useful in correcting the deformity.
- 6. FIRST STAGE REPAIR -The procedure may be staged; -The first stage involves the rotation of the foreskin to cover the defect created by mobilizing the distal urethra.
- 7. SECOND STAGE REPAIR -A second stage addresses the creation of the distal urethra and meatus. -If defective, the bladder and prostatic urethra are repaired.
- 8. PROCEDURE -When epi-spadiasoccurs in the distal penis, the tissues are mobilized and sutured over the defect. -The urethral meatus is opened at the tip of the glans penis.
- 9. CREATING SUPRA PUBIC INCISION -A supra pubic incision is made to expose the prostatic urethra. -Redundant tissue of the prostatic urethra is excised.
- 10. SUTURING WITH CATGUT -Absorbable sutures, e.g., catgut approximate the prostatic urethra and vesical neck over a probe or catheter, -recreating the continence mechanism.
- 11. PLACEMENT OF SUPRAPUBIC CYSTOSTOMYTUBE -A suprapubic cystostomy tube is placed to provide temporary urinary diversion. -The skin is closed.
- 12. -For Preparationof the Patient, Skin Preparation, Draping, Equipment, and Instrumentation, Supplies, and Special Notes, see Hypospadias Repair,.
- 13. SUPPLIES Add suprapubiccystostomy catheter, e.g., Pezzer, Malecot. Thanking you.