100 / 330
100
28
TH
CONGRESS OF THE ESPU
MATERIAL AND METHODS
A retrospective audit was performed for all children diagnosed with EO between July 2011 - June
2013. Following audit, recommendations were made for selective use of antibiotics, to bring practice
in line with EAU guidelines. We suggested urinary tract ultrasound and use of antibiotics only if
urinalysis was positive. A prospective audit was conducted to assess compliance.
RESULTS
Initial audit identified eighty-three boys with EO. Fifty-eight had urinalysis, only five had positive
cultures. Sixty-eight were prescribed antibiotics. Forty-four underwent renal tract US. No new
urogenital anomalies were detected. Following dissemination of results and implementation of
recommendations, the prospective re-audit was undertaken. This identified thirty-one patients with
a diagnosis of EO. There was no positive urinalysis, but 58% still received antibiotics. Urinary tract
ultrasound was done in 12.5%.
CONCLUSIONS
Following the introduction of new guidelines, there was a reduction in antibiotic prescribing from
82% to 58% and a reduction in OP renal tract US from 44% to 12.5%. Prescribing of antibiotics for
EO is an entrenched behaviour. For engagement and adoption of new guidelines, leadership and
frequent, effective reinforcement is required. It is important we ensure the implementation of such
guidelines to aid antibiotic stewardship and ensure appropriate use of renal tract US.
13:59–14:02
S9-4 (PP)
GONADAL FUNCTION AND REPRODUCTIVE SYSTEM
ANATOMY IN POST PUBERAL PRUNE BELLY SYNDROME
PATIENTS
Alessandro TAVARES
1
, Francisco TIBOR-DÉNES
1
, Marcello COCUZZA
2
,
Bruno TISEU
2
, Amilcar GIRON
1
and Miguel SROUGI
2
1) Hospital das Clinicas Sao Paulo Medical School, Uropediatric Unit, Urology Department, Sao Paulo, BRAZIL -
2) Hospital das Clinicas Sao Paulo Medical School, Urology, Sao Paulo, BRAZIL
PURPOSE
Prune belly syndrome (PBS) is characterized by abdominal wall muscle hypoplasia, urinary tract
dilatation and bilateral intra-abdominal testis. No spontaneous paternity has been reported to date
and infertility is usually taken for granted. Our purpose was to gain insight on the causes of infertility
in PBS by evaluating reproductive system anatomy and gonadal function in a cohort of post puberal
PBS patients.
MATERIAL AND METHODS
We contacted all patients 14 years-old or older that had undergone surgical reconstruction at our
Institution since 1987. Age at orchidopexy, type of orchidopexy (with or without ligation of gonadal
vessels), testicular volumes and positions and last serum creatinin were recorded. A pelvic MRI
to evaluate prostate size, seminal vesicles and vas and serum FSH, LH and testosterone were
ordered. Sperm analysis and analysis of urine after masturbation were performed when the patient
and family consented.
RESULTS
Fifteen patients had data from physical examination and hormonal profile and were included in
this study. Mean age was 18.2 years. Mean age at orchidopexy was 17 months. Fourteen (93.3%)
patients had both testes in scrotum. Mean testicular volume was 6.9 cc (2.1 to 9.4 cc). Eight patients
collected semen. Mean concentration was 5.07 million/mL. Motile sperm was found in 5 patients