Complete female epispadias with urinary incontinence: A single-stage perineal urethroplasty and cystoscopic-guided bladder neck plication

Isolated female epispadias without bladder exstrophy is an extremely rare congenital anomaly. The presenting features of female epispadias are urinary incontinence and abnormal anatomical features. A 4-month-old girl presented with primary urinary incontinence since birth. On physical examination, she had a bifid clitoris and labia minora along with an anteriorly placed introitus and wide-open bladder neck. The vagina and hymen were normal. With the diagnosis of isolated complete female epispadias, a single-stage reconstruction of the urethra, labia minora and clitoris was performed along with cystoscopic-guided bladder neck plication. This index case highlights the surgical technique and the necessity to operate on these patients at a younger age in infancy with a single-stage perineal repair to achieve better functional and cosmetic outcomes.