The modified Cantwell-Ransley repair for exstrophy and epispadias: 10-year experience

Purpose: We evaluate our experience with the modified Cantwell-Ransley epispadias repair technique to determine the complications and long-term results. Materials and Methods: The modified Cantwell-Ransley epispadias repair was performed during the last 10 years in 93 males of whom 79 had classic bladder exstrophy and 14 had complete epispadias. Primary repair was performed in 65 boys with classic bladder exstrophy and 12 with epispadias, and secondary repair was done after prior failed reconstruction in 14 boys with classic exstrophy and 2 with complete epispadias. Results: At mean followup of 68 months 87 patients had a horizontal or downward angled penis while standing. The incidence of urethrocutaneous fistulas was 23% in the immediate postoperative period and 19% at 3 months. A urethral stricture at the proximal anastomotic area developed in 7 patients and 5 (4 with exstrophy and 1 with epispadias) had minor skin separations of the dorsal penile skin closure. Catheterization or cystoscopy in 77 cases revealed an easily negotiable neourethral channel. Conclusions: The modified Cantwell-Ransley epispadias repair produces an excellent functional and cosmetic result.