Assessment of urinary continence in epispadias: review of 94 patients.

Between 1946 and 1980, 82 male and 12 female patients with epispadias were evaluated at our institution. Factors critical to the achievement of complete continence include deferral of an operation until the patient is at least 3 years old, a well developed bladder with adequate capacity and musculature, and maturation of the prostate at puberty in boys. Complete continence was obtained in 10 of the 12 female patients (83 per cent). Of 53 incontinent male patients undergoing an operation 18 (34 per cent) obtained complete urinary continence in the initial postoperative period but control was delayed until puberty in 19 additional male patients, for an over-all success rate in 37 of 53 patients (70 per cent). The significant increase in continence with the onset of puberty demonstrates the importance of expectant management of progress in a boy in relation to the potential contribution of prostatic maturation in the development of urinary control.