Clinical Report: Adult Presentation of Isolated Male Epispadias

Overview

This report details a unique case of isolated male epispadias presenting in adulthood, highlighting the surgical challenges and outcomes associated with the modified Cantwell-Ransley procedure. The patient achieved satisfactory functional and cosmetic results three months post-surgery.

Background

Isolated male epispadias is a rare congenital condition that typically requires surgical correction in infancy. Adult presentations are exceedingly uncommon and can lead to significant psychosocial challenges. Understanding surgical techniques and outcomes in this population is crucial for improving patient care and addressing their unique needs.

Data Highlights

Key Findings

• Isolated male epispadias occurs in approximately 1 in 117,000 live births.
• Adult presentations are rare, with outpatient treatment rates as low as 0.6 per 100,000 annually.
• The modified Cantwell-Ransley procedure was successfully performed on a 35-year-old male with isolated epispadias.
• Postoperative recovery included transient minor glans necrosis, which healed spontaneously.
• At three months follow-up, the patient reported normal urinary function and satisfaction with sexual outcomes.

Clinical Implications

Surgical correction of isolated male epispadias in adults is feasible and can lead to significant improvements in both function and quality of life. Clinicians should be aware of the potential for psychosocial challenges and the need for tailored surgical approaches in this population.

Conclusion

The case demonstrates that surgical intervention for isolated male epispadias in adulthood can yield positive outcomes. Continued research and standardized management protocols are essential for optimizing care for these patients.

References

1. European Association of Urology-European Society of Paediatric Urology Guidelines on Paediatric Urology: Summary of 2024 Updates. Part II - ScienceDirect
2. Isolated Male Epispadias Repair: Long-Term Outcomes
3. Determinants of Penile Size After Puberty in Individuals with Hypospadias
4. Hernia — Management of a Giant Inguinoscrotal Hernia with Preoperative Pneumoperitoneum: A Case Study Highlighting an Unexpected Complication and Literature Review
5. Exploring the Use of Tunica Vaginalis or Dartos as Secondary Layer Coverage in Distal and Mid-Shaft Penile Hypospadias Repair
6. Single-stage correction of proximal hypospadias utilizing in situ tubularization of the transverse preputial island flap
7. European Association of Urology-European Society of Paediatric Urology Guidelines on Paediatric Urology: Summary of 2024 Updates. Part II - ScienceDirect
8. Isolated Male Epispadias Repair: Long-Term Outcomes