MULTICENTER EXPERIENCE WITH THE MITCHELL TECHNIQUE FOR EPISPADIAS REPAIR

Purpose: We present a multicenter experience using the Mitchell epispa dias technique to determine if satisfactory results could be obtained by various pediatric urologists at multiple centers using the same tec hnique to repair epispadias. This particular technique involves comple te disassembly of the penis into 2 separate hemicorporeal glandular bo dies and a separate urethral plate, and relies on the unique blood sup ply to the epispadiac phallus. Materials and Methods: A total of 17 bo ys 11 months to 21 years old underwent the Mitchell procedure for epis padias at 4 institutions by 6 different surgeons between 1994 and 1996 . One patient in this group had undergone prior epispadias repair, whi ch had failed. Results: At followup (mean 13.5 months) 3 boys had pinp oint penopubic fistulas, which resolved spontaneously in 2. The 21-yea r-old patient had a complete wound dehiscence. All boys with intact re pairs have straight erections, orthotopic meatus and satisfactory appe arances. There were 15 boys with a conical glans appearance and 1 exhi biting glandular disproportion. There was 1 episode of postoperative p yelonephritis. Conclusions: The Mitchell technique for repair of episp adias is reproducible and successful in the hands of pediatric urologi sts from different centers. Chordee is reliably corrected, erectile fu nction preserved, the urethra ventrally situated in an anatomically pr ecise fashion and satisfactory cosmesis achieved.