Robert L. Lebowitz, M.D. Children' s Hospital, Harvard Medical School Boston, Massachusetts

Epispadias

A 10 year-old girl was followed for three years because of intermittent day and night wetting. She had been normally toilet-trained but leaked urine intermittently throughout the day and night. She did have dry periods, however. Finally, at the time of cystoscopy elsewhere, it was noticed that she had a bifid clitoris and the diagnosis of epispadias was made. VCUG showed a pubic symphysis that was wider than normal (Figure 1) and a short urethra (Figure 2). The width of the pubic symphisis should be less than 1 cm at any age. She underwent epispadias repair and bladder neck reconstruction.