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19–22 APRIL, 2017, BARCELONA, SPAIN
16:32–16:35
S11-7 (PP)
HUMAN DECELLULARISED DERMIS FOR COMPLEX
RECONSTRUCTION OF THE LOWER URINARY TRACT:
PRELIMINARY REPORT OF 24 CASES
Anna RADFORD, Alexander TURNER, Junaid ASHRAF
and Ramnath SUBRAMANIAM
Leeds Childrens Hospital, Department of Paediatric Urology, Leeds, UNITED KINGDOM
PURPOSE
Reconstruction of anomalies of the lower urinary tract can be challenging. Deficiency of good
quality urethral and peri-urethral tissue is recognised as a contributory factor in development of
post-urethroplasty complications. Acellular matrices (ACMs) provide a potential solution but select-
ing the most appropriate strategy remains undetermined. We report our experience and outcomes
in patients who have had human dermal acellular matrix (HDACM) implanted as part of complex
urethral reconstruction.
MATERIAL AND METHODS
From 2013-2016, 24 boys (median age 5.5 years (range 2.8-15.5)) underwent urethral reconstruc-
tion using a NDACM as a peri-urethral splint. Indications for surgery included: urethral fistulae
(n=12), redo-urethroplasty (n=8), and urethral diverticulum (n=2), urethral stenosis (n=2). Outcome
data was collected prospectively.
RESULTS
All 24 boys made a good initial recovery. Median follow-up was; to 6 months (1-24 months). Wound
complications in 3/24 (12.5 %), resulted in one urethral fistula. One child, with diverticulum, devel-
oped a tiny fistula at the proximal end of the repair, which seems to have resolved conservatively,
with follow-up in clinic. Of those seen in clinic only 1/17 the parents reported to be unhappy with
the outcome (5.88%). Uroflowmetry so far (n=10), demonstrated bell-shaped curves (10/10), mean
QMax = 9.6 ml/sec (± 2.65).
CONCLUSIONS
These preliminary results in those boys who have had a HDACM implanted suggest it may be
utilised as an adjunct to support and waterproofing in complex urethroplasty cases when there is
a lack of quality, healthy tissues. Further work is required to formally assess integration and long
term follow-up clinically needs to be acquired.