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19–22 APRIL, 2017, BARCELONA, SPAIN
VS-5 (VS without presentation)
ANTERIOR URETHRAL SYRINGOCELE WITH POSTERIOR
URETHRAL VALVES: A RARE ASSOCIATION
Anand UPASANI
1
, Ruth KWONG
2
, Anu PAUL
2
, Nav JOHAL
2
, Bernadita TRONSCOSO-
SOLAR
2
and Peter CUCKOW
2
1) Great Ormond Street Hospital, London, Paediatric Urology, Eastleigh, UNITED KINGDOM - 2) Great Ormond Street
Hospital, Paediatric Urology, London, UNITED KINGDOM
PURPOSE
We present a 4 day old neonate with bilateral antenatal hydroureteronephrosis and renal impair-
ment with a rare combination of anterior urethral syringocoele and posterior urethral valves. We
would like to share the endoscopic findings correlated with preoperative imaging.
MATERIAL AND METHODS
After initial acute management of renal impairment, pre-operative imaging with renal ultrasound was
performed and it confirmed findings of bilateral hydroureteronephrosis. A micturating cystourethro-
gram revealed a torturous urethra and a dilated posterior urethra, raising the suspicion of anterior
urethral pathology as well as posterior urethral valves. Cystourethroscopy confirmed the diagnoses.
The valves were ablated and the anterior urethral syringocoele was deroofed.
RESULTS
The baby made an uneventful recovery and is now voiding spontaneously with a good stream and
has stable renal function.
CONCLUSIONS
It is a rare occurrence for two urethral pathologies to present at the same time. Posterior ure-
thral valves are well described and have an incidence of 1 in 8000 live births. Anterior urethral
syringocoele is an uncommon congenital abnormality of the male urethra characterised by cystic
dilatation of bulbo-urethral gland ducts. It can be asymptomatic and usually occurs in isolation. Our
experience with this case with dual urethral pathology will enhance awareness and knowledge in
investigating and managing these conditions.
VS-6 (VS without presentation)
ROBOTIC-ASSISTED LAPAROSCOPIC ARTIFICIAL URINARY
SPHINCTER AND MACE PROCEDURE ON A PEDIATRIC
PATIENT
Miguel CASTELLAN, Paulo MOSCARDI, Natalia BALLESTEROS,
Abd-El-Rahman ABD-EL-BARR and Mariarita SALVITTI
Nicklaus Children's Hospital - University of Miami, Pediatric Urology, Miami, USA
INTRO AND OBJECTIVES
Our patient is a 6-year-old girl with a history of spina bifida, intrinsic sphincter deficiency and
chronic constipation. The patient and her family opted for robotic assisted artificial urinary sphincter
(RALAUS) placement and Malone antegrade continent enema (MACE) procedure.
METHODS
We used the DaVinci Xi surgical platform with 5 ports to include a 12 mm assistant port in the right
lower quadrant for the passage of the AUS implants as well as the site of the future MACE stoma.
For the MACE, the appendix was isolated and the cecum was imbricated to create an anti-refluxing.
Its distal end was left closed for the remainder of the surgery.