118 / 330
118
28
TH
CONGRESS OF THE ESPU
16:11–16:14
S11-4 (PP)
★
ULTRASONOGRAPHIC ASSESSMENT OF BLADDER
VOLUMES IN CHILDREN UNDERGOING PENILE SURGERY:
DOES THE TYPE OF ANESTHESIA MATTER?
Yuval BAR-YOSEF
1
, Margaret EKSTEIN
2
, Ron FLAISHON
2
, Eyal AMAR
2
,
Avi WEINBROUM
2
and Jacob BEN-CHAIM
1
1) Dana-Dwek Children’s Hospital, Tel-Aviv Medical Center, Peditaric Urolgy, Tel-Aviv, ISRAEL - 2) Dana-Dwek
Children’s Hospital, Tel-Aviv Medical Center, Peditaric Anesthesia, Tel-Aviv, ISRAEL
PURPOSE
There are scant data reporting postoperative ultrasonographically-measured bladder volumes
in children undergoing penile surgery under different types of anesthesia. ultrasonographically-
measured post-voiding residual bladder volumes indexed to age-appropriate capacity, and time
elapsed between the end of surgery and spontaneous voiding, in children after penile surgery given
different types of anesthesia were compared.
PATIENTS AND METHODS
This prospective, observational study, encompassed children undergoing circumcision, distal hypo-
spadias repair, or repair of urethro-cutaneous fistula. Children between 4 months and 12 years were
randomized to anesthesia with caudal block, intravenous fentanyl or penile block, in association
with inhaled general anesthesia. Bladder volumes were measured before surgery, and immediately
after voiding for the first time. Time to first post-surgery void was also recorded.
RESULTS
Thirty-one children completed all assessments, including 12 who underwent caudal block, 9 in-
travenous fentanyl anesthesia and 7 penile blocks. The first post-void bladder residual volumes
were highest in the caudal and lowest in the penile block children (27.5ml vs 17.3ml, p=0.003).
The time elapsing between the end of surgery and first voiding was significantly longer (p=0.02)
in the fentanyl group (232 minutes) in comparison to caudal block (178 minutes) and penile block
(150 minutes).
CONCLUSIONS
None of the anesthetic techniques provoked postoperative urinary retention after minor penile sur-
gery in children. The penile block appears superior to caudal block or to fentanyl-based anesthesia
with regard to post-operative recovery of normal micturition.
16:14–16:26
Discussion