215 / 330
215
19–22 APRIL, 2017, BARCELONA, SPAIN
MATERIAL AND METHODS
A retrospective review of 3360 children who underwent Circumplast (CC) and Plastibell circumci-
sion (PC) under local anaesthesia at a community clinic from May 2014 to October 2016. Parents
were given detailed information and consented preoperatively in children with potential risks. This
was provided verbally and in written format.
All complications were reviewed by a paediatric surgeon. All preputial adhesions were separated
under anaesthetic cream. Buried penis was treated conservatively. Incomplete circumcisions were
corrected by excision of excess skin. Acquired phimosis was treated by steroid, simple double
incision of the scar and surgical reconstruction. Complications were further looked for CC and PC.
Follow-up visits were arranged in all cases.
RESULTS
A total incidence of cosmetic complications in this cohort was 2.3% (n=77/3360) in NMC. Causes
of adherent penile skin or incomplete penile exposure included preputial adhesions (1.3%), buried
penis (0.5%), acquired phimosis (0.4%) and incomplete circumcision (0.1%). There is no signifi-
cant difference in the complications between CC (2.2 % n=22/1002) and PC (2.3% n= 55/2357)
(p>0.05). Preputial adhesions were higher in PC (1.5%) than CC (0.8%) but not statistically signifi-
cant. Acquired phimosis was treated by steroid (n=2), simple double incision of the scar (n=6) and
surgical reconstruction (n=8). The mean age of the children was 6.5 ± 1.4 months (median 2.1).
Mean follow-up was 96 days (range 5 to 373).
CONCLUSIONS
Children with cosmetic complications following NMC by disposable rings can be prevented by
meticulous perioperative management. Parental education and surgical expertise is required to
minimise these complications.
S19-16 (P without presentation)
GENITOURINARY INVOLVEMENT
AND URINARY DIVERSIONS IN PAEDIATRIC PATIENTS
WITH EPIDERMOLYSIS BULLOSA
Eleni PAPAGEORGIOU
1
, Naima SMEULDERS
2
, Imran MUSHTAQ
3
, Peter CUCKOW
3
,
Anna MARTINEZ
4
and Abraham CHERIAN
3
1) Great Ormond Street Hospital NHS Trust, Pediatric Urology, London, UNITED KINGDOM - 2) Great Ormond Street
Hospital, NHS Trust, Pediatric Urology, London, UNITED KINGDOM - 3) Great Ormond Street Hospital, NHS Trust,
Pediatric Urology, London, UNITED KINGDOM - 4) Great Ormond Street Hospital, NHS Trust, Pediatric Dermatology,
London, UNITED KINGDOM
INTRODUCTION
Epidermolysis Bullosa (EB) is a rare genetic skin disorder with variable systemic involvement. We
present our experience over the last 30 years, focussing on genitourinary involvement and urinary
diversions.
PATIENTS AND METHODS
Retrospective review of all EB patients with urological problems between1986-2016 classified
into Group A: specific urinary-tract anomaly and Group B: general-urology of childhood. Statistical
analysis: Fisher-test.
RESULTS
Twenty male patients were identified: 8(40%) junctional-EB (subtype:1-Herlitz, 4-non-Herlitz,
3-non-Herlitz with pyloric-atresia), 9(45%) dystrophic-EB (5-recessive, 3-dominant, 1-transient-
epidermolysis-of-the-newborn) and 3(15%) simplex-EB.