Causes
Epispadias is an uncommon and partial form of a spectrum of failures of abdominal and pelvic fusion in the first months of embryogenesis known as the exstrophy - epispadias complex. While epispadias is inherent in all cases of exstrophy it can also, much less frequently, appear in isolation as the least severe form of the complex spectrum. It occurs as a result of defective migration of the genital tubercle primordii to the cloacal membrane, and so malformation of the genital tubercle, at about the 5th week of gestation. Treatment
The main treatment for isolated epispadias is a comprehensive surgical repair of the genito-urinary area usually during the first 7 years of life, including reconstruction of the urethra, closure of the penile shaft and mobilisation of the corpora. The most popular and successful technique is known as the modified Cantwell-Ransley approach. In recent decades however increasing success has been achieved with the complete penile disassembly technique despite its association with greater and more serious risk of damage. Prognosis
Even with successful surgery, patients may have long-term problems with:
incontinence, where serious usually treated with some form of continent urinary diversion such as the Mitrofanoff
depression and psycho-social complications
sexual dysfunction

References


== External links ==
Frovatriptan, sold under the brand name Frova, is a triptan drug developed by Vernalis for the treatment of migraine headaches and for short term prevention of menstrual migraine. The product is licensed to Endo Pharmaceuticals in North America and Menarini in Europe. Medical uses
Frovatriptan is used in the treatment of migraine. Available forms
It is available as 2.5 mg tablets. Contraindications
Frovatriptan should not be given to patients with:

Ischemic heart disease
Cerebrovascular syndrome
Peripheral vascular disease
Uncontrolled hypertension
Hemiplegic or basilar migraine

Side effects
Rare, but serious cardiac events have been reported in patients with risk factors predictive of CAD. These include: coronary artery vasospasm, transient myocardial ischemia, myocardial infarction, ventricular tachycardia and ventricular fibrillation. Pharmacology
Pharmacodynamics
Frovatriptan is a serotonin receptor agonist, with high affinity for the 5-HT1B/1D receptors. It has no significant effects on the GABAA mediated channel activity and benzodiazepine binding sites. Frovatriptan inhibits excessive dilation of arteries that supply blood to the head. Pharmacokinetics
Frovatriptan has a terminal elimination half-life of approximately 26 hours, making it the longest within its class. Society and culture
US licensing
Frovatriptan is available only by prescription in the United States and Canada, where a secondary New Drug Approval (sNDA) was filed in July 2006. References
External links
Frova (manufacturers website)
Frovatriptan Succinate  (patient information)
FDA labeling