Correction of the anomalies of the penis with hypospadias and bladder exstrophy (review)

Exstrophy-epispadias complex is a range of urogenital malformations vary in severity from epispadias to classic bladder exstrophy and cloacal exstrophy. Description and study of exstrophy epispadias complex began with the VII century. Only in the beginning of the twentieth century successful results, ensuring optimal quality of life, were achieved. Exstrophy-epispadias complex - one of the most difficult for treat pathologies in the practice of pediatric urology. Currently, the frequency rate is 1 for 100,000 live births. The proportion of boys among those patients with higher 1.5-6 times than girls. Clinically, this anomaly is characterized by a visible defect in the lower urinary tract as evaginated combination with either the bladder wall (classical schistocystis) or digested with urethra (with epispadias). Anatomical changes in penile urethra occur when epispadias splitting up to the meatus, the location of which varies depending on the form of epispadias. The head of the penis flattened, the foreskin covers only its ventral surface. Also, due to differences pubic bones and hypoplasia tunica on the dorsal surface of the penis is shortened, a dorsal varying degrees of deformation. Furthermore, most boys with epispadias have total incontinence. The aim of exstrophy-epispadias complex correction is to achieve continence with preservation of the upper urinary tract and functional and cosmetically reconstruction of the penis. There is still no consensus on the choice of steps of treatment of such patients.