Primary reconstruction of epispadias in exstrophy: modified Cantwell technique with external rotation of the corpora cavernosa

Objective : to present a modification of the Cantwell epispadias reconstruction technique aimed at lengthening and straightening the penile shaft. Patients and methods : a prospective follow-up of all boys with classic exstrophy who underwent the proposed technique was conducted. Inclusion criteria were patients with exstrophy with a postoperative followup period of more than 12 months, who had a urethral plate longer than 15 mm. Results : between November 2021 and June 2023, penile reconstruction was performed on 36 patients with exstrophy. Of this cohort, 14 boys aged 12 to 47 months met the inclusion criteria and underwent a modified reconstruction. The surgery and the postoperative period were not accompanied by serious complications. In the medium term, penile appearance, erectile shape, and urination were assessed both in an outpatient setting and by photo and video recording. Conclusion : the presented technique, applied in a homogeneous group of patients with classic bladder exstrophy, allowed to achieve penile elongation, improved appearance, erectile function, and elimination of dorsal curvature.