278 / 330
278
28
TH
CONGRESS OF THE ESPU
There are many alternatives to surgical treatment of urinary incontinence caused
Objective: To present our experience in implementing mini -sling (MS) as minimally invasive option
in selected patients.
MATERIAL AND METHODS
Prospective study. 31 neurogenic patients were included. 20 females and 11 males (1.8: 1). Period:
November 2009 to June 2016. Average age: 11.8 years.
A MS was indicated for treatment of SI.
All in clean intermittent catheterization (CIC).
The initial urodynamic pressure loss (LP) was 23.3 (15-40 cm H20)
Perineal approach in men and vaginal approach in women.
Retrograde urethral pressure (PUR) was measured initial and subsequent to the introduction of MS
16 patients (51.6%) had previous urologic surgeries.
In 10 patients (32.2%) concomitant urological procedures were performed.
Clinical and urodynamic evaluation and monitoring.
RESULTS
Mean operating time: 40 minutes.
PL increased to 33.4 cm H20 (increased 43.3%).
24 patients (77.4%) remain dry for more than 3 hours.
Complications: A patient with self-limited bleeding. Another with urethral stricture requiring continent
urinary stoma. A male presented surgical wound dehiscence requiring toilette. 1 case of erosion
No man presented difficulty CIL after implantation.
Follow up (median): 42 (2-81) months.
CONCLUSIONS
The MS is a safe, feasible and useful option for the treatment of neurogenic urinary incontinence IE.
In this indications we should know that patientes depend on CIC and it wil be succesful with PL prior
to placement under 20 cm H20.
S25-14 (P without presentation)
SACRAL NEUROMODULATION IN CHILDREN
WITH NEUROGENIC BLADDER: IS IT EFFECTIVE IN ALL?
Giovanni MOSIELLO
1
, Ana Ludy LOPES MENDES
2
, Ilaria JANSEN
3
,
Antonio ZACCARA
4
, Maria Luisa CAPITANUCCI
4
and Mario DE GENNARO
5
1) Bambino Gesù Children’s Hospital, Paediatric Surgery , Neuro-Urology, Rome, ITALY - 2) Bambino Gesù Pediatric
Hospital, Department of Surgery, Rome, ITALY - 3) AMC, Department of Urology and Department of biomedical
engineering and physics,, Amsterdam, NETHERLANDS - 4) Bambino Gesù Pediatric Hospital, Urology and Robotic,
Rome, ITALY - 5) Bambino Gesù Pediatric Hospital, Robotic and Surgery, Rome, ITALY
PURPOSE
In pediatric patients with neurogenic bladder (NBD), sacral neuromodulation (SNM) role is unclear
and results are controversial. The aim of this study is to analyse the effectiveness of SNM in children
with congenital and acquired NBD, for identifying a selective group candidate with better functional
response.
MATERIAL AND METHODS
From 2008 to 2016, 45 patients with NBD non-responding to anticholinergics or onabotulinum toxin
A have been treated with SNM, according to our protocol approved by our Institution. We have
evaluated only patients with NBD congenital and acquired, aged <18 years and with a minimum
follow-up for at least 24 months. Patients have been operated after a written consent was obtained