ESPU Congress 2017 - Abstract book

316

CONGRESS OF THE ESPU

12:40–12:50

S2-5 (LO)

EARLY ESTABLISHMENT OF CLEAN INTERMITTENT

CATHETERISATION IN INFANTS WITH BLADDER

EXSTROPHY IS WELL TOLERATED

David KEENE, Doru NICOARA, Vytis KAZLAUSKAS, Alessandra SCALAS,

Beverley WHITNALL and Raimondo Maximilian CERVELLIONE

Royal Manchester Children’s Hospital, Paediatric Urology, Manchester, UNITED KINGDOM

PURPOSE

The use of clean intermittent catheterisation (CIC) is a mainstay in the management of neuropathic

bladder patients. Bladder exstrophy (BE) patients may also experience incomplete bladder emptying

following reconstructive surgery. CIC is poorly tolerated when introduced in older bladder exstrophy

children. The authors aimed to verify if CIC would be well tolerated if introduced in infancy.

MATERIAL AND METHODS

In this prospective study initiated in 2012, CIC was introduced at discharge following BE closure

in infants twice a day using an 8F lofric catheter in males and a 6F lofric catheter in females. The

frequency of CIC was increased if there were significant volumes drained or hydronephrosis and

decreased if there were no significant urine volumes drained. The compliance to CIC was assessed

at the time of follow up clinics at 3, 6 and 12 months postoperatively.

RESULTS

Twenty-six patients with classic BE were commenced on CIC following BE closure. Twenty-five

patients successfully continued regular CIC. One male patient stopped CIC because the child was

very active and would not keep still enough to allow CIC to be done. Twenty patients continued

to receive CIC twice a day at follow up. Two patients had reduced their frequency of CIC after

6 months because of regular spontaneous voiding and low residual volumes at catheterisation. CIC

frequency was increased in 2 patients to treat high residual volumes. The median length of follow

up was 10 months (6.5-23.4).

Females

Males

Number of patients

Successful establishment of ISC

100%

93%

Age at establishment of ISC (months)

6.2 (5.6-7.9)

6.5 (5.1-7.8)

Age at latest follow up (years)

1.6 (0.8-3.6)

1.2 (0.9-2)

Number of times CIC

performed per day after

6 months

CONCLUSIONS

Early establishment of CIC by parents in bladder exstrophy patients is well tolerated and can be

successfully continued into early childhood.