160 / 238
160
29
th
CONGRESS OF THE ESPU
RESULTS
30 patients diagnosed with ATM were identified, median age 8.9 years (0.5–16). Twelve showed
LUT or bowel symptoms, either at presentation (7) or follow-up. The most common urological pres-
entation was acute urinary retention(6). One also developed priapism and faecal incontinence, 3 had
additional constipation and one presented with urgency. One patient had isolated constipation. Of
the 6 with initial retention, two had complete resolution of their bladder symptoms, but one with pria-
pism has residual erectile dysfunction. LUTs appeared during follow-up in five. The only significant
ultrasonographic abnormality was post-void residual volume after trial of void (4) or during follow-up
(2). Five children (5 - 17years) underwent video-urodynamics showing small cystometric capacity in
5, high leak point pressure and detrusor overactivity in three, incomplete bladder emptying in two,
and poor compliance in one. Five patients were managed with CIC, 7 with anticholinergics and four
with intravesical injection of Botox
®
. After a median follow-up of 5 years, 7 patients have recovered
normal bladder function, four have persistent LUTS, and one remains on CIC and anticholinergics.
All patients with initial bowel symptoms recovered function and four developed constipation/soiling
during follow-up, requiring laxatives and/or rectal enemas for management.
CONCLUSIONS
Persistent bowel and bladder dysfunction is common in ATM and symptoms may appear during
follow-up. Renal ultrasound and urodynamic investigation are recommended to guide treatment if
symptoms persist.
08:25–08:40
Discussion
08:40–08:43
S21-6 (PP)
BLADDER AND BOWEL DYSFUNCTION IN CHILDREN
WITH ACQUIRED BRAIN INJURY: A MISSED PROBLEM?
Enrico CASTELLI
1
, Rita CHIMINELLO
2
and Giovanni MOSIELLO
3
1) Bambino Gesù Pediatric Hospital, Pediatric Neuro-Rehabilitation Unit, Rome, ITALY - 2) Bambino Gesù Pediatric
Hospital, Neuro-Rehabilitation Unit, Rome, ITALY - 3) Bambino Gesù Pediatric Hospital, Pediatric Neuro-Urology Unit,
Department of Surgery, Rome, ITALY
PURPOSE
Bladder and bowel dysfunctions (BBD) in children with spinal cord injuries (SCI) have been evalu-
ated as in cerebral palsy (CP). Scant data are available in acquired brain injury (ABI). Aim of our
study is to evaluate BBD risk and incidence in ABI children.
MATERIAL AND METHODS
All new patients admitted from the 1
st
July to the 30
th
September 2017, aged 3 to 18 years old, were
evaluated. Data were collected considering clinical diagnosis, ICIQ Scale, Wee-Fim Scale, Bristol
scale, Gross Motor Function Classification System (GMFCS) and the Communication Funcion
Classification System (CFCS). Statistical analysis was performed with Microsoft SPSS,p<0,001 was
considered significative.
RESULTS
60 new patients were admitted: 30 presented CP and 17 ABI, 3 SCI, 10 others congenital pa-
thologies. About ABI patients none of them had never evaluated before by pediatric urologist. No
statistical difference is present between ABI and CP.