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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.