Causes, incidence, and risk factors:
The causes of epispadias are unknown at this time. It is believed to be related to improper development of the pubic bone.
In boys with epispadias, the urethra generally opens on the top or side of the penis rather than the tip. However, it is possible for the urethra to be open the entire length of the penis.
In girls, the opening is usually between the clitoris and the labia, but may be in the belly area.
Epispadias can be associated with bladder exstrophy, an uncommon birth defect in which the bladder is exposed, inside out, and sticks through the abdominal wall. However, epispadias can also occur alone or with defects.
Epispadias occurs in 1 in 117,000 newborn boys and 1 in 484,000 newborn girls. The condition is usually diagnosed at birth or shortly thereafter.
Persistent urinary incontinence can occur in some persons with this condition even after several operations.
Upper urinary tract (ureter and kidney) damage and infertility may occur.