Epispadias is a congenital genitourinary malformation which occurs in males and females.
In males, epispadias may involve only the penis or may be associated with exstrophy of other organs such as the bladder.
The opening of the urethra can be situated anywhere on the upper surface of the penis. Usually, the penis is of a small size. It is also frequently bifid.
In females, the opening of the urethra is present anteriorly. It frequently opens in the clitoris, in which case the clitoris may be bifid.
In all patients with epispadias and exstrophy, a number of studies are necessary before reconstructive surgery can be performed.
Management is surgical, aiming for urinary continence and functional genital reconstruction  .
Isolated epispadias is relatively easy to correct by surgical means. Patients suffering from epispadias along with any form of exstrophy require complex reconstructive surgery .
Therefore, the prognosis after surgery varies depending from patient to patient. The post-surgical survival rates for all surgical cases are excellent.
In most cases, bladder function and urinary continence can be restored if proper surgery is performed  .
Epispadias is almost purely a developmental disorder. No causal agents or risk factors have been identified. There is very little evidence to support familial occurrence .
Isolated epispadias is a very rare condition. It is present in only 1 in around 117,000 live births in males and 1 in 484,000 live births in females.
Epispadias associated with any form of exstrophy is much more frequent. Epispadias associated with bladder exstrophy occurs in 1 in 30,000 live births. Cloacal exstrophy is much rarer and occurs in 1 in 200,000 to 400,000 live births .
Males are affected much more commonly; the male to female ratio being 2.3:1. Besides, whites are affected much more commonly as compared to blacks.
Parallel to this process, the anterior abdominal wall also undergoes maturation. Normally, the mesenchyme migrates between the ectoderm and endoderm of the lower abdominal wall. This provides stability to the wall and prevents any form of exstrophy from developing.
Failure of the mesenchyme to migrate between those layers causes the cloacal membrane to become unstable. If the cloacal membrane ruptures before it has fully descended into the caudal area of the embryo, a number of anomalies including cloacal and bladder exstrophy can develop.
In classic epispadias, there is no bladder or cloacal exstrophy but the external meatus of the urethra lies on the dorsum of the penis. This happens when the bladder has formed normally but the urethra has not completely tubularized .
There are no guidelines for prevention of epispadias.
It affects both males and females. In males, typically the external meatus of the urethra is situated at some point on the dorsum of the penis. Isolated epispadias however, is very rare. Exstrophy of the bladder is frequently present in association with epispadias.
In the females, epispadias is said to be present when the urethra is positioned very anteriorly, where it may open in the clitoris or even further ahead .
Epispadias is a condition in which the opening of the urinary outlet lies on the upper surface of the penis instead of the tip. It may be associated with other abnormalities in which the bladder or intestines protrude from the abdominal wall.
All of these abnormalities arise during fetal development inside the mother. Surgery is required to correct these abnormalities. The results of surgery are usually favorable.