ARTICLE TYPE : RESEARCH ARTICLE
Published on : 01 Jan 2026, Volume - 1
Journal Title : WebLog Journal of Urology | WebLog J Urol
Source URL: 
https://weblogoa.com/articles/wju.2026.a0105
Permanent Identifier (DOI) : 
https://doi.org/10.5281/zenodo.18211810
Ureteric Orifice Size in Primary Epispadias: A “New” Observation
2Department of Paediatric Urology, Great Ormond Street Hospital for Children NHS Trust, London, UK
Abstract
Objectives: To investigate the observation that children with primary epispadias frequently exhibit stenotic ureteric orifices, in contrast to patients with classic bladder exstrophy.
Design: Retrospective observational study.
Setting: Single tertiary paediatric urology centre.
Participants: Children with incontinent primary epispadias who underwent bladder reconstruction between January 2005 and December 2006.
Primary Outcome Measures: Ureteric orifice calibre, size of ureteric catheter successfully inserted, and presence or absence of upper tract dilatation on imaging.
Results: Eleven patients (8 males, 3 females; age range 12–68 months, mean 43 months) were included. Three patients (1 male, 2 females) had ureteric orifices that accepted 6F catheters without difficulty. In the remaining eight patients (6 males, 2 females), one or both ureteric orifices were too narrow to accept a 6F catheter during primary reconstruction. These orifices admitted only 3F–4F catheters, often after dilatation. Pre‑ and postoperative ultrasonography demonstrated no upper tract dilatation in any patient.
Conclusions: A ureteric orifice size of at least 6F is generally expected in children of this age group undergoing bladder reconstruction. The unexpectedly high prevalence of stenotic ureteric orifices in primary epispadias suggests a previously under‑recognised anatomical association. This may reflect abnormal trigonal development, complementing the well‑described continence abnormalities in this population. The contrast with bladder exstrophy highlights potential embryological differences between these conditions.
Keywords: Primary Epispadias; Ureteric Orifice Stenosis; Ureteric Catheterisation; Bladder Reconstruction; Trigonal Development; Paediatric Urology; Bladder Outlet Reconstruction; Embryological Anomalies; Ureteric Calibre; Bladder Exstrophy–Epispadias Complex
Citation
More B, Patel RV, Jahur S, Cuckow P. Ureteric Orifice Size in Primary Epispadias: A “New” Observation. WebLog J Urol. wju.2026.a0105. https://doi.org/10.5281/zenodo.18211810