A case of female epispadias

Objective

To present a case of unrecognized female epispadias.

Design

Case report.

Setting

University-based reproductive endocrinology and fertility clinic.

Patient(s)

A 16-year-old girl with epispadias, history of mild urinary incontinence, auditory neuropathy, and functional hyperandrogenism.

Intervention(s)

None.

Main Outcome Measure(s)

Peripheral blood array–based comparative genomic hybridization.

Result(s)

The patient was referred for evaluation of excessive weight gain, secondary amenorrhea, and abnormal external genitalia. Examination under anesthesia revealed bilateral labia minora hypertrophy, bifid clitoris, and a patulous urethra, consistent with female epispadias. Hormonal evaluation showed functional hyperandrogenism, and peripheral blood array–based comparative genomic hybridization showed no chromosomal deletions or duplications.

Conclusion(s)

Female epispadias is a rare abnormality, not commonly recognized by most practitioners. The diagnosis is supported by a history of urinary incontinence and physical findings of bifid clitoris and patulous urethra. The condition can have serious physical and psychological consequences leading to a gross disruption of social function.

Key Words: Epispadias, bifid clitoris, urinary incontinence, patulous urethra