ABSTRACT
The bladder exstrophy-epispadias complex forms a spectrum of rare defects that extend from simple glanular epispadias to complex cloacal exstrophy.
Male epispadias (Figure 57.1) is a deformity in which the urethra opens on the dorsum of the penis instead of at its tip (one in 100 000 live births). There is associated dorsal chordee. In female epispadias (Figure 57.2), the urethral opening extends to the clitoris, which is bifid (one in 400 000 live births). In both male and female epispadias, the urinary sphincters may
be incomplete, with separation of the symphysis pubis, leading to incontinence.
