{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:34:57Z","timestamp":1787070897305,"version":"build-2736575974"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T00:00:00Z","timestamp":1741046400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Isolated male epispadias typically presents with preputial defects and dorsal urethral dehiscence. A less common subtype, known as concealed epispadias, is distinguished by an intact prepuce. Despite its clinical relevance, there is limited literature on this variant. In this study, we retrospectively analyzed the clinical data of 86 pediatric patients with isolated male epispadias treated in Beijing Children\u2019s Hospital (Beijing, China) from May 2004 to July 2023, including 19 cases of concealed epispadias and 67 of nonconcealed epispadias. We compared clinical characteristics, preoperative diagnostics, surgical techniques, postoperative outcomes, and sexual function during follow-up between the concealed and nonconcealed groups. No significant differences were observed between the two groups regarding surgical methods, postoperative complications, or rates of urinary incontinence. However, notable distinctions were found in the age at initial diagnosis, timing of surgery, frequency of incontinence, location of the urethral meatus, and postoperative urinary incontinence scores (all\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.05). Given the absence of penopubic epispadias in concealed cases, we categorized glans and penile epispadias within nonconcealed epispadias as distal epispadias (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 40) and subsequently compared them with concealed epispadias cases. The postoperative urinary incontinence scores did not differ significantly between the concealed and distal epispadias groups. These findings suggest that concealed epispadias represents a relatively milder form of the condition, characterized by the absence of penopubic involvement, lower rates of urinary incontinence, and favorable surgical outcomes. However, the intact prepuce in concealed cases underscores the need for careful identification and early diagnosis.\n                  <\/jats:p>","DOI":"10.4103\/aja2024114","type":"journal-article","created":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T03:01:36Z","timestamp":1741057296000},"page":"502-507","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Comparative analysis of isolated male epispadias: concealed versus nonconcealed cases in a Chinese tertiary hospital"],"prefix":"10.4103","volume":"27","author":[{"given":"Jia-Yi","family":"Li","sequence":"first","affiliation":[{"name":"Department of Urology, Beijing Children\u2019s Hospital, Capital Medical University, National Center for Children\u2019s Health, Beijing 100045, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Urology, Beijing Children\u2019s Hospital, Capital Medical University, National Center for Children\u2019s Health, Beijing 100045, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng-Cheng","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Bao\u2019an Maternity and Child Health-care Hospital, Shenzhen 518102, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zong-Han","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Urology, Beijing Children\u2019s Hospital, Capital Medical University, National Center for Children\u2019s Health, Beijing 100045, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong-Cheng","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Urology, Beijing Children\u2019s Hospital, Capital Medical University, National Center for Children\u2019s Health, Beijing 100045, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Ping","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Urology, Beijing Children\u2019s Hospital, Capital Medical University, National Center for Children\u2019s Health, Beijing 100045, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,3,4]]},"reference":[{"key":"R1-20250716","doi-asserted-by":"crossref","first-page":"337.e1","DOI":"10.1016\/j.jpurol.2015.03.023","article-title":"Prospective study on the incidence of bladder\/cloacal exstrophy and epispadias in Europe","volume":"11","author":"Cervellione","year":"2015","journal-title":"J Pediatr Urol"},{"key":"R2-20250716","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1007\/s11934-014-0472-8","article-title":"The surgical management of male epispadias in the new millennium","volume":"15","author":"Cho","year":"2014","journal-title":"Curr Urol Rep"},{"key":"R3-20250716","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/S0090-4295(95)97778-3","article-title":"Epispadias with phimosis:an unusual variant of the concealed penis","volume":"45","author":"McCahill","year":"1995","journal-title":"Urology"},{"key":"R4-20250716","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1007\/s11255-015-0947-7","article-title":"Double breasting of bladder neck and posterior urethra for continence in isolated peno-pubic epispadias","volume":"47","author":"Bhat","year":"2015","journal-title":"Int Urol Nephrol"},{"key":"R5-20250716","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/j.jpurol.2016.07.016","article-title":"Concealed epispadias associated with a buried penis","volume":"12","author":"Sol Melgar","year":"2016","journal-title":"J Pediatr Urol"},{"key":"R6-20250716","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.urology.2017.07.001","article-title":"Is concealed epispadias a rare variant?","volume":"109","author":"Shahat","year":"2017","journal-title":"Urology"},{"key":"R7-20250716","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1111\/j.1464-410X.2012.11719.x","article-title":"Congenital completely buried penis in boys:anatomical basis and surgical technique","volume":"112","author":"Liu","year":"2013","journal-title":"BJU Int"},{"key":"R8-20250716","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1002\/nau.20041","article-title":"ICIQ:a brief and robust measure for evaluating the symptoms and impact of urinary incontinence","volume":"23","author":"Avery","year":"2004","journal-title":"Neurourol Urodyn"},{"key":"R9-20250716","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1016\/j.juro.2008.05.060","article-title":"The pediatric penile perception score:an instrument for patient self-assessment and surgeon evaluation after hypospadias repair","volume":"180","author":"Weber","year":"2008","journal-title":"J Urol"},{"key":"R10-20250716","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1016\/S0022-5347(05)67245-X","article-title":"The modified Cantwell-Ransley repair for exstrophy and epispadias:10-year experience","volume":"164","author":"Surer","year":"2000","journal-title":"J Urol"},{"key":"R11-20250716","doi-asserted-by":"crossref","first-page":"2382","DOI":"10.1097\/01.ju.0000143880.13698.ca","article-title":"Results of 265 consecutive proximal hypospadias repairs using the Thiersch-Duplay principle","volume":"172","author":"Amukele","year":"2004","journal-title":"J Urol"},{"key":"R12-20250716","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.urology.2016.07.018","article-title":"Results of epispadias repair using the modified Cantwell-Ransley technique","volume":"99","author":"Bar-Yosef","year":"2017","journal-title":"Urology"},{"key":"R13-20250716","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.jpurol.2013.06.005","article-title":"Epispadias in boys with an intact prepuce","volume":"10","author":"Bos","year":"2014","journal-title":"J Pediatr Urol"},{"key":"R14-20250716","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.urology.2015.09.040","article-title":"Concealed epispadias:report of two cases and review of literature","volume":"90","author":"Garge","year":"2016","journal-title":"Urology"},{"key":"R15-20250716","doi-asserted-by":"crossref","first-page":"108406","DOI":"10.1016\/j.ijscr.2023.108406","article-title":"Surgical correction of epispadias associated with buried penis","volume":"108","author":"Sabra","year":"2023","journal-title":"Int J Surg Case Rep"},{"key":"R16-20250716","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1007\/s00247-007-0495-0","article-title":"Congenital anomalies of the male urethra","volume":"37","author":"Levin","year":"2007","journal-title":"Pediatr Radiol"},{"key":"R17-20250716","doi-asserted-by":"crossref","first-page":"6896","DOI":"10.1038\/srep06896","article-title":"Embryonic origin and compartmental organization of the external genitalia","volume":"4","author":"Herrera","year":"2014","journal-title":"Sci Rep"},{"key":"R18-20250716","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1016\/j.jpurol.2015.05.030","article-title":"Pathogenesis of bladder exstrophy:a new hypothesis","volume":"11","author":"Satish Kumar","year":"2015","journal-title":"J Pediatr Urol"},{"key":"R19-20250716","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1016\/S0022-3468(99)90499-2","article-title":"Epispadias repair using the Mitchell technique","volume":"34","author":"Narasimhan","year":"1999","journal-title":"J Pediatr Surg"},{"key":"R20-20250716","doi-asserted-by":"crossref","first-page":"80.e1","DOI":"10.1016\/j.jpurol.2019.10.027","article-title":"Long-term outcomes in primary male epispadias","volume":"16","author":"Thomas","year":"2020","journal-title":"J Pediatr Urol"},{"key":"R21-20250716","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1055\/s-0033-1343083","article-title":"A novel technique of concealed penis repair","volume":"24","author":"Kim","year":"2014","journal-title":"Eur J Pediatr Surg"},{"key":"R22-20250716","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.asjsur.2014.04.006","article-title":"Modified prepuce unfurling for buried penis:a report of 12 years of experience","volume":"38","author":"Chin","year":"2015","journal-title":"Asian J Surg"},{"key":"R23-20250716","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/s12894-015-0044-3","article-title":"A new surgical technique for concealed penis using an advanced musculocutaneous scrotal flap","volume":"15","author":"Han","year":"2015","journal-title":"BMC Urol"},{"key":"R24-20250716","doi-asserted-by":"crossref","first-page":"2636","DOI":"10.1016\/j.juro.2008.08.048","article-title":"Pathophysiology and management of urinary incontinence in case of distal penile epispadias","volume":"180","author":"Canon","year":"2008","journal-title":"J Urol"},{"key":"R25-20250716","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1007\/s11934-008-0028-x","article-title":"The exstrophy-epispadias complex","volume":"9","author":"Eeg","year":"2008","journal-title":"Curr Urol Rep"},{"key":"R26-20250716","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1016\/S0022-5347(01)68118-7","article-title":"Urodynamic findings in children with isolated epispadias","volume":"162","author":"Kaefer","year":"1999","journal-title":"J Urol"}],"container-title":["Asian Journal of Andrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aja2024114","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:38:29Z","timestamp":1787067509000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aja2024114"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,4]]},"references-count":26,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/aja2024114","relation":{},"ISSN":["1745-7262","1008-682X"],"issn-type":[{"value":"1745-7262","type":"print"},{"value":"1008-682X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,4]]},"assertion":[{"value":"2024-07-13","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-03","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}