Epispadias: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Epispadias?
A urologist (a doctor who treats the urinary system and the genitals) usually treats epispadias. Because it is present at birth, a pediatrician (a children's doctor) is often involved too. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is epispadias?
Epispadias is a rare defect that is present at birth. The urethra does not develop into a full tube. The urethra is the tube that carries urine out of the body from the bladder. With epispadias, the urine leaves the body from the wrong place.
Epispadias can be part of a group of birth defects called the exstrophy-epispadias complex. This group ranges from epispadias and classic bladder exstrophy to exstrophy of the cloaca, which is the most severe form. Depending on how severe it is, the group of defects can involve the urinary system, the bones and floor of the pelvis, the belly wall, and the genitals. Sometimes the spine and the anus are involved too.
Symptoms
The signs are different in males and females.
- In males, the penis is short and wide and has an abnormal curve.
- The urethra most often opens on the top or side of the penis instead of the tip.
- The urethra may be open along the whole length of the penis.
- In females, the clitoris and labia (the folds of skin around the vagina) look abnormal.
- In females, the urethral opening is often between the clitoris and the labia, but it may be in the belly area.
- Females may have trouble controlling urination, which is called urinary incontinence.
Doctors may also see other signs, such as urinary tract infections and a widened pubic bone. Urine may flow backward toward the kidney, which is called reflux.
Causes and who gets it
The causes of epispadias are not known. It may happen because the pubic bone does not develop properly. Epispadias can occur with bladder exstrophy, a rare birth defect in which the bladder is open through the wall of the abdomen. It can also occur with other birth defects. The condition occurs more often in boys than girls.
How doctors diagnose it
Epispadias is most often diagnosed at birth or soon afterward. Tests may include a blood test of kidney function and an ultrasound of the urinary system and genitals. Doctors may also use a pelvic x-ray, or MRI and CT scans, depending on the condition. Another test is an intravenous pyelogram (IVP), a special x-ray of the kidneys, bladder, and ureters.
Treatment
People who have more than a mild case of epispadias will need surgery. Leakage of urine can often be repaired at the same time. A second surgery may be needed soon after the first surgery or later in life. Surgery can help the person control the flow of urine. It will also fix the appearance of the genitals.
Some people may still have urinary incontinence after surgery. Damage to the ureters (the tubes that carry urine from the kidneys) and the kidneys, and infertility, may occur.
When to see a doctor
Contact your health care provider if you have any questions about the appearance or function of your child's genitals or urinary tract. Urinary tract infections are one sign of epispadias, so tell your provider if your child has one. Call 911 or go to the emergency room if a child has bleeding that will not stop, trouble or abnormal breathing, a seizure, or pain that is severe or getting worse.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either type of doctor can help you find a urologist, coordinate care between specialists, and follow your child's health over time.
Common questions
Is epispadias present at birth?
Yes, epispadias is a defect that is present at birth. It is most often diagnosed at birth or soon afterward.
Does epispadias need surgery?
It depends on how severe it is: people who have more than a mild case will need surgery. Surgery can help the person control the flow of urine and fix the appearance of the genitals. A second surgery may be needed either soon after the first or later in life.
Is epispadias more common in boys or girls?
It is more common in boys than in girls.
Can epispadias harm the kidneys?
Yes, it can in some people, because kidney and ureter damage may occur. Urinary tract infections and backward flow of urine toward the kidney are also listed as signs.
Sources
- MedlinePlus - Epispadias
- NIH Genetic and Rare Diseases Information Center - Exstrophy-epispadias complex
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
