ESPU Congress 2017 - Abstract book

CONGRESS OF THE ESPU

11:20–11:23

S7-8 (PP)

VOIDING OUTCOME OF MALE PROXIMAL EPISPADIAS

Sajid SULTAN, Philip RANSLEY, Sadaf ABA UMER KODWAVWALA, Bashir AHMED,

Adnan SARWAR, Firasat MAJID, Hina YOUSUF and Adeeb Ul Hassan RIZVI

Sindh Institute of Urology & Transplantation, Philip G. Ransley Department of Paediatric Urology, Karachi, PAKISTAN

PURPOSE

To evaluate the voiding outcome of bladder neck reconstruction in (incontinent) male proximal

epispadias.

MATERIAL AND METHODS

Records of 17 male patients who underwent proximal epispadias repair and bladder neck recon-

struction (BNR) from 2008 to 2016 were retrospectively reviewed for the presence and degree of

pubic diastasis, pre operative early morning voided volume, details of cystogram and cystoscopy

especially bladder capacity and its relationship with estimated bladder capacity (EBC) for the age.

The epispadias repair was performed by Cantwell Ransley technique and BNR by modified

Young’s technique. Voiding outcome was evaluated by voided volume, dry intervals, presence of

urge, stress incontinence and nocturnal enuresis.

RESULTS

Mean age at presentation was 7.2 +/- 3.1 years. Of the seventeen, no pubic diastasis (Group A)

was found in 5 (29.5%), mild diastasis (Group B) in 6 (35%), moderate (Group C) in 4 (23.5%) and

severe diastasis (Group D) in 2 (12%). Pre BNR mean early morning voided volume was 242mls

(60% of EBC)in Group A, 188 mls (52% EBC) in Group B,147 mls (36% EBC)in Group C and

45 mls (16% EBC) in Group D. Combined single stage epispadias repair and BNR was performed in

5 (29%) whereas 12 (71%) underwent staged procedure for epispadias and BNR. The age at BNR

was 10.8 +/- 2.8 years. Mean follow up period is 23 +/-28 months.

Two patients lost to follow up. Dry interval ranged 4 -5 hours in 12 /15 (80%) and 1 -2 hours in

3/15 (20%). Urge incontinence was present in 4/ 15(26%), stress incontinence in 11/15 and noctur-

nal enuresis in 8/15.

CONCLUSIONS

Our results are encouraging especially for those with no or mild to moderate pubic diastasis. This is

one of the largest and unique series of a rare abnormality, i.e. voiding outcome of isolated epispa-

dias of late presentation from a developing country.