Cantwell-Ransley epispadias repair in male epispadias and bladder exstrophy.

A total of 16 boys (8 with primary epispadias and 8 with bladder exstrophy) underwent epispadias reconstruction as a 1-stage procedure. Reverse meatal advancement of MAGPI, ventral transposition of the neourethra and chordee correction by corporeal rotation or "cavernocavernostomy" were performed as primary (13 boys) or secondary/salvage (3 boys) procedures. At a mean followup of 27 months all children had a horizontal or downward angled penis while standing. Catheterization in 10 children revealed an easily negotiable neourethral channel. Minor revision surgery was necessary in the area of previous paraexstrophy flaps in 2 cases, and 1 child required neourethral tapering and proximal anastomotic revision. The Cantwell-Ransley epispadias repair produces a good functional and cosmetic result.