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2014 | 9 | 6 | 807-810

Article title

Surgical treatment of stress urinary incontinence and vaginal prolapse for the woman with epispadia


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Patient K.L., 32 years old. Menses started at thirteen years old, C 5/28. Patient had two vaginal deliveries in 2004 and 2010. Dysplasia cervicis uteri CIN2-3 was diagnosed in 2007, subsequently diathermoconisation cervicis uteri was performed. The woman was born with epispadia - extrophia of urethra to abdominal wall, without pubic bone. At the age of 8 she underwent an operation in Moscow. During the operation the neck of the bladder was formed as well as urethra, which opens in vulva, place of clitoris. When she was 8 years old, her bladder capacity was 30 ml, in teenage years - 90 ml. The patient also reported history of recurrent urinary tract infections. 2011.08.02 Patient took medical advice in out patient department Kaunas university hospital with a complaint of stress urinary incontinence: when going, coughing, sneezing, doing exercises, having sex and at rest of time. Also it was the sexual intercourse problems with orgasm. She was urinating 8 times per day but none at night. Gynecological examination: absence of pubic bone, vulva is abnormal: absence of labium major and clitoris. Urethra opens into the place of clitoris. Front and back walls of vagina are moving down (POP-Q II-III stage prolapsed). Cervix of uterus is short, epithelised (after diathermoconisation). Uterus is normal in size, in retro-versio-flexio position. - without pathology. Sonography: internal genital organs without pathology. Boney, Valsalva test are positive, Ulmstein test negative. Urodynamic study revealed a bladder capacity of 134 ml, voided volume 173 ml. Pressure of detrusor - 10cmH2O. Compliancenormal, max flow rate 13,8 ml/s, voiding time 24 s. Spontaneous contractions of detrusor were not observed. Surgical treatment: 2011.10.10 TOT (tension obturator tape). Anterior and posterior colporrhaphy and perineoplastic was performed. There were no complications during and after surgery. On the 2 day after operation patient was released from hospital.










Physical description


1 - 12 - 2014
16 - 8 - 2014


  • Lithuanian University of Health Sciences, Kaunas, Lithuania
  • Lithuanian University of Health Sciences, Kaunas, Lithuania
  • Lithuanian University of Health Sciences, Kaunas, Lithuania
  • Lithuanian University of Health Sciences, Kaunas, Lithuania


  • [1] Shaikh N, Arif F. Female epispadias. J Pak Med Assoc. 2009 May; 59(5):314–316
  • [2] Atilgan D, Uluocak N, Erdemir F, Parlaktas BS. Female epispadias: a case report and review of the literature. Kaohsiung J Med Sci. 2009 Nov; 25(11):613–616 http://dx.doi.org/10.1016/S1607-551X(09)70565-0[Crossref]
  • [3] Grady RW, Mitchell ME. Management of epispadias. Urol Clin North Am. 2002 May; 29(2):349–60, vi. http://dx.doi.org/10.1016/S0094-0143(02)00027-7[Crossref]
  • [4] Bhat AL, Bhat M, Sharma R, Saxena G. Singlestage perineal urethroplasty for continence in female epispadias: a preliminary report. Urology. 2008 Aug; 72(2):300–3; discussion 303–4. Epub 2008 May 2 http://dx.doi.org/10.1016/j.urology.2007.09.073[Crossref]
  • [5] Tantibhedhyangkul J, Copland SD, Haqq AM, Price TM. A case of female epispadias. Fertil Steril. 2008 Nov; 90(5):2017.e1–3. Epub 2008 Mar 7 http://dx.doi.org/10.1016/j.fertnstert.2007.12.055[Crossref]
  • [6] VanderBrink BA, Stock JA, Hanna MK. Aesthetic aspects of reconstructive clitoroplasty in females with bladder exstrophy-epispadias complex. J Plast Reconstr Aesthet Surg. 2010 Dec; 63(12):2141–5. Epub 2010 Mar 29 http://dx.doi.org/10.1016/j.bjps.2010.02.005[Crossref]
  • [7] Gupta NP, Dorairajan LN and Chahal R. Total genitourinary reconstruction in adult female epispadias: A report of 2 cases and literature review. International Urogynecology Journal Volume 9,Number 1, 55–57, DOI: 10.1007/BF01900545 [Crossref]
  • [8] Ebert AK, Reutter H, Ludwig M, Rösch WH. The exstrophy-epispadias complex. Orphanet J Rare Dis. 2009 Oct 30;4:23 http://dx.doi.org/10.1186/1750-1172-4-23[Crossref]
  • [9] Tantibhedhyangkul J, Copland SD, Haqq AM, Price TM. A case of unrecognized female epispadias. Fertil Steril. 2008 Nov; 90(5): 2017.e1–2017.e3 http://dx.doi.org/10.1016/j.fertnstert.2007.12.055[Crossref]

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