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19–22 APRIL, 2017, BARCELONA, SPAIN
S12: AUGMENTATION / DIVERSION
Moderators: Agustín Serrano (Spain), Raimund Stein (Germany)
ESPU Meeting on Thursday 20, April 2017, 16:58–17:30
16:58–17:01
S12-1 (PP)
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HISTOLOGICAL FINDINGS AND FREQUENCY
OF URINARY TRACT INFECTIONS FOLLOWING URINARY
BLADDER AUGMENTATION IN CHILDREN – LONG-TERM
FOLLOW-UP
Daniel KARDOS
1
, Zoltan KISPAL
2
, Andrew PINTER
1
and Peter VAJDA
1
1) University of Pecs, Department of Paediatrics, Pecs, HUNGARY - 2) Medical University of Graz, Department
of Paediatric and Adolescent Surgery, Graz, AUSTRIA
PURPOSE
In a longer follow-up, authors repeated their previous prospective study about correlation between
histological findings and urinary tract infections following urinary bladder augmentation using differ-
ent parts of intestinal tract.
MATERIAL AND METHODS
Between 1987 and 2016, 90 bladder augmentations were performed at the author’s institute.
Seventy-three patients (16 gastrocystoplasty, 32 ileocystoplasty, 25 colocystoplasty) with a mean
11.3 (range 4-24) years of follow up time were included in the present study. Mean age at operation
was 11 years. Histological samples from the native bladder, the anastomotic line and from the intes-
tinal segment used for augmentation were taken endoscopically and urinary cultures were collected
during a follow-up protocol biannually. Correlation between frequency of urinary tract infections
and degree of histological changes (normal, inflamed, metaplastic or dysplastic) were statistically
evaluated using chi-squared, ANOVA and independent samples T-tests.
RESULTS
In patients with colocystoplasty 1 in-situ carcinoma, 5 squamous metaplasia, 1 colonic-type
metaplasia and 3 dysplastic changes were noted. Following gastrocystoplasty 4 squamous and
2 colonic-type metaplasia were found. After ileocystoplasty 3 squamous metaplasia were noted.
A significantly higher frequency of urinary tract infections (59%) was found following colocystoplasty
vs gastrocystoplasty (38%) and ileocystoplasty (42%). The degree of histological changes in colonic
and ileal mucosa significantly correlated with the rate of urinary tract infection.
CONCLUSIONS
Our prospective and long-term findings support the previous hypothesis that the frequency of uri-
nary tract infections plays an important role in the histological alterations following urinary bladder
augmentation.