85
19–22 APRIL, 2017, BARCELONA, SPAIN
S7-11 (P without presentation)
SUCCESSFUL PREGNANCY AND DELIVERY
IN WOMEN WITH COMPLEX LOWER URINARY TRACT
RECONSTRUCTION
Francisco DENES, Lorena OLIVEIRA, Bruno CESARINO, Marcos MACHADO
and Amilcar GIRON
Hospital das Clinicas da Faculdade de Medicina - University of Sao Paulo, Urology, Sao Paulo, BRAZIL
PURPOSE
The purpose of this work was to determine the outcomes of pregnancy and delivery in patients with
complex lower urinary tract reconstruction.
MATERIAL AND METHODS
We retrospectively reviewed patients with complex lower urinary tract reconstruction who became
pregnant and successfully delivered their babies from 1987 to 2016. The patients included in this
study were treated for genitourinary malformations such as bladder exstrophy and neuropathic
bladder secondary to spinal dysraphism. We collected data on demographics, caracteristics of
the malformation, method of delivery (vaginal or C-section), upper urinary tract alterations during
pregnancy, catheterization, UTI, continence and perioperative complications.
RESULTS
Seventeen women had 24 successfull pregnancies and deliveries over a 29-years period. Twenty
two were delivered via C-section and 2 were delivered vaginally. Four patients had spontaneous
abortions (one miscarriage each). Two developed severe hydronephrosis during pregnancy which
required antecipation of the C-section. Six developed urinary incontinence during pregnancy.
Six had symptomatic UTIs (2/6 febrile). A midline incision was made in 22, Pfannenstiel in none.
Intraoperative complications were identified in 1/24 (reservatory perforation) which needed reopera-
tion. Seven 7 had genital prolapse after pregnancy. Tubal ligation was performed in 2 cases.
CONCLUSIONS
Despite the increased risk related to complex lower urinary tract reconstruction during child-
hood, adult patients can achieve successfull pregnancies and deliveries with adequate urologic
surveillance.
S7-12 (P without presentation)
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.