A case of isolated female epispadias and our approach to treatment

Abstract

Cases of isolated female epispadias (IFE) without exstrophy of the bladder are quite rare. The clinical symptoms of IFE are abnormal external genitalia with primary urinary incontinence. Our patient was a 7-year-old girl with total urinary  incontinence. Physical examination revealed a patulous urethra, bifid labia minora, and a bifid clitoris. The vagina and hymen appeared to be normal. Uroflowmetry demonstrated an overflow-type pathological voiding pattern with low voiding pressure. A voiding cystourethrogram showed no indications of reflux. To treat our IFE patient, we performed a single stage genital approach reconstruction of the urethra, clitoris, and labia minora. Follow up with the patient ensured that she was continent and that her external genitals took on an acceptable appearance.

Keywords:  Female epispadias; Patulous urethra; Bifid clitoris; Urinary incontinence