Re: Pediatric Urology

Posted By Don on April 19, 1999 at 09:45:39
I have a 2 yr. old son who was born with a bladder extrophy (Epispadias), to date he has had all appropriate surgeries.  The Urologist says he's diappointed in the size of my son's penis, right now the size is not a problem but when he gets older, it will be.  I've heard of all the "penis enlargment" advertisments and I can only assume they are scams. What are some other options, if any, can be done to help my son's condition.
P.S. His testicals and scrotum are the normal size.  

[hfhs M.D.-AK]

Posted By HFHS M.D.-AK on April 20, 1999 at 11:20:52

Dear Don,
When operating for bladder extrophy, there are four key concerns that must be addressed to ensure a functional and cosmetically acceptable penis.  These include: dorsal chordee(curvature), urethral reconstruction, penile skin closure and the glandular reconstruction(head of penis).
It is possible to achieve some lengthening with release of chordee at the time of the initial bladder closure, but it is often necessary to perform formal penile elongation procedures at a later date.
It is not uncommon for children with epispadias to have a rather small penis.  Often reconstruction of the urethra and penile lengthening are performed between the ages of two and three.  Most patient undergo testosterone stimulation prior to this procedure to increase the available skin for this complex reconstruction operation.   The actual lengthening can be achieved with further dissection of the suspensory ligaments and old scar, dissection of the corpora cavernosa from the inferior pubic ramus, and lengthening of the urethral groove is essential as well as mobilization of the penile shaft skin.
I do not know the specifics of your case or prior reconstructive history.  You need to ask your pediatric urologist for his or her recommendations on how to proceed.  They will help you in your decision process and make further recommendations or even a referral if necessary.
This information is provided for general medical educational purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.  More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword:Pediatric Urology, epispadius










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