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19–22 APRIL, 2017, BARCELONA, SPAIN
MATERIAL AND METHODS
A 10 year old boy with a history of spina bifida underwent a split appendix procedure with placement
of a double umbilical stoma. Laparoscopy was used to mobilize the cecum and appendix followed
by a pffanenstiel approach for the remaining portion of the procedure. Both stomas were located in
the umbilicus and catheters were left in place post procedure.
RESULTS
The patient is using both stomas without trouble, is continent and satisfied with the procedure.
CONCLUSIONS
The double umbilical stoma is our prefered approach the split-appendix procedure. This film demon-
strates this technique which results ina cosmetically superior yet fully functional result.
17:15–17:30
Discussion
S12-6 (P without presentation)
DOES THE QUALITY OF LIFE WAS ACHIEVED
IN CONGENITALLY INCOMPETENT BLADDER OUTLET
ON THE EXPENSE OF RENAL FUNCTION?
Helmy OMAR
1
, Tamer HELMY
2
, Ashraf HAFEZ
1
and Mohammed DAWABA
1
1) Urology and nephrology center, Pediatric urology, Mansoura, EGYPT - 2) Urology & Nephrology center Mansoura,
Paediatric Urology, El Mansoura, EGYPT
PURPOSE
To evaluate parent’s satisfaction and quality of life issues in children who underwent augmentation
cystoplasty and continent cutaneous outlet aiming to achieve continence and to assess its impact
on renal function.
MATERIAL AND METHODS
We retrospectively evaluated patients who u outlet between June 1993 and May 2015 in for
congenitally incompetent bladder outlet. All patients were evaluated at time of last follow up by
health related quality of life questionnaire (HRQoL) and estimated GFR using Cockcroft equation.
Continence is defined as staying dry for at least 3 hours.
RESULTS
With a median (range) follow up of 65 (5-267) months,154 patients were evaluable at time of follow
up. Mean age at surgery was 7.9+3.8 years. Continence was achieved in 123 patients (79.9%).
Higher QoL score has been encountered in continent patients (figure) (p= 0.002), in patients who
don’t require additional surgical intervention (p= 0.001) and in those in whom the appendix was
used as continent catheterisable channel (p=0.04). The mean + SD estimated preoperative GFR
ishigher than the postoperative one (77.2 + 33.4 mg/dl Vs 53.3 + 26.1 mg/dl) (95% CI; 19.6-28.3,
P < 0.0001).
CONCLUSIONS
Although augmentation ileocystoplasty and continent continuous outlet are essential in achieving
continence and improving quality of life in children with congenitally incompetent bladder outlet, but
it has adverse effect on renal function. Thus, close monitoring of renal function is essential in those
children.