OPTIMIZATION OF COMPREHENSIVE TREATMENT FOR TOTAL AND SUBTOTAL EPISPADIAS IN CHILDREN

The aim of this study was to improve treatment outcomes in children with total and subtotal epispadias by optimizing surgical techniques. A retrospective analysis was performed on 44 out of 71 patients treated between 1998 and 2024 at the Department of Pediatric Surgery of Tashkent State Medical University and the Republican Scientific and Practical Center for Minimally Invasive and Endoscopic Pediatric Surgery. The patients were aged 1 to 11 years. In 79.5% of cases, penile length was reduced twofold compared to age norms, and in 9.0% it was reduced by 2.5 times; all patients had penile torsion and complete urinary incontinence. Complete urinary continence was achieved in 45.5% of cases, and partial continence in 18.2%, with overall good and satisfactory outcomes in 63.7% of patients. Although one-stage orthoneourethroplasty allows simultaneous penile straightening and urethral reconstruction, it does not fully eliminate urinary incontinence. Therefore, further improvement of sphincteroplasty and pubic symphysis approximation techniques is recommended.