ESPU Congress 2017 - Abstract book

CONGRESS OF THE ESPU

Number of patients with

histological features

Cystitis cystica /

glandularis

21 (72%)

11 (85%)

Squamous

metaplasia

17 (59%)

6 (46%)

Intestinal

metaplasia

5* (17%)

8* (61%)

CONCLUSIONS

Intestinal metaplasia appears to be more prevalent in those with severely polypoid bladder tem-

plates. A careful strategy is needed for these patients to maximise the chance for successful BE

closure and the authors suggest polypectomy prior to BE closure. Polyp regrowth does not appear

to be a major problem as 5% required a second polypectomy prior to BE closure.

10:59–11:14

Discussion

11:14–11:17

S7-6 (PP)

COMPLETE PRIMARY REPAIR OF BLADDER EXSTROPHY:

A CONTEMPORARY SERIES WITH TIME TO EVENT

ANALYSIS

Tamer HELMY

, Hesham ORBAN

, Helmy OMAR

, Ahmed GALAL

, Ashraf HAFEZ

and Mohammed DAWABA

1) Urology & Nephrology center Mansoura, Paediatric Urology, El Mansoura, EGYPT - 2) Urology and Nephrology

Center, Paediatric Urology, Mansoura, EGYPT

PURPOSE

To report long term outcomes after complete primary repair of bladder exstrophy in a tertiary referral

center.

MATERIAL AND METHODS

we retrospectively reviewed the records of all patients who underwent classic bladder exstrophy

closure between June 1998 and May 2010. Patients who were subjected to complete primary repair

were filtered for further analysis. Data reviewed included demographic data, history of previous

attempts of closure, surgical technique; follow up after exstrophy closure; continence status, meas-

ures performed to achieve continence and status at last follow up.

RESULTS

This cohort included 43 boys and 15 girls. Previous attempts of closure were done in 28 children.

After 110 months, 2 achieved volational voiding. BNI was tried in 21. Two patients only were dry.

BNR with augmentation cystoplasty was performed in 36 children. 26 patients were dry. Continent

stoma was used for all patients after BNR. Bulbourethral sling was tried in 15 children (8 after

BNI-3 after BNR and 4 denovo patients). Three patients after BUS could achieve partial dryness.

Bladder neck transection was performed in 17 children (8 denovo patients, 7 after BNR and 2 after

BUS).

CONCLUSIONS

Long term results after complete primary repair were unsatisfactory and this in turn aborts the past

expectations of reduction of continence surgeries. Based on these dismal results, staged repair now

is considered the standard of care approach for our neonatal exstrophy babies.