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11–14 APRIL, 2018, HELSINKI, FINLAND
09:31–09:34
S22-5 (PP)
★
LOWER URINARY TRACT SYMPTOMS
AND HIRSCHSPRUNG DISEASE: PREVALENCE, RISK
FACTORS AND MANAGEMENT
Matthieu PEYCELON
1
, Liza ALI
1
, Elisabeth CARRICABURU
1
, Lise NATIO
1
, Daphné
MICHELET
2
, Chrystele MADRE
3
, Christine VITOUS-BROT
3
, Dominique BERREBI
4
,
Christine GRAPIN-DAGORNO
5
, Alaa EL GHONEIMI
1
, Arnaud BONNARD
6
and
Annabel PAYE-JAOUEN
1
1) Hôpital Robert-Debré, Paediatric Urology, Paris Cedex 19, FRANCE - 2) Hôpital Robert-Debré, Paediatric
Anesthesiology, Paris, FRANCE - 3) Hôpital Robert-Debré, Paediatric Intensive Care Unit, Paris, FRANCE - 4) Hôpital
Robert-Debré, Paediatric Pathology, Paris, FRANCE - 5) Hôpital Robert-Debré, Pediatric Urology and Surgery, Paris,
FRANCE - 6) Hôpital Robert-Debré, Pediatric Surgery, Paris, FRANCE
PURPOSE
To define the prevalence and to identify the risk factors of lower urinary tract symptoms (LUTS) and
outcomes after transanal endorectal pull-through (EPT) and Duhamel procedures for Hirschsprung
disease (HD).
MATERIAL AND METHODS
Data were retrospectively reviewed in all patients over 5 years with HD in our center between
2004 and 2012. They were divided into two groups, (A) EPT, and (B) Duhamel. Analyzed param-
eters included patients characteristics (birth weight, term, age at surgery), pathological findings,
postoperative complications, current clinical examination (Bristol and DVSS score, uroflowmetry).
Exclusion criteria: intellectual disability, definitive endostomy. Statistical analysis: Student and
Fisher tests.
RESULTS
111 patients were included (A=85; B=26) and 27 patients (24 %) (A=19; B=8) with a median age
of 6.5 years (A=6.1; B=8.5, p>0.05) were totally analyzed. Median follow-up was 83.4 months.
Median age at surgery was 32 days (A=18; B=186, p=0.04). Constipation occurred in 11 patients
(40.7 % (A=8; B=3, p>0.05)) and prevalence of LUTS was 22 % (A=4; B=2, p>0.05). Median DVSS
score was 10.8 (A=11.5; B=10, p>0.05) with a median Qmax of 17 mL/s (A=16.3; B=18.5, p>0.05).
Two patients (10.5 %) had detrusor-sphincter dyssynergia after EPT who needed catheterization
through a Mitrofanoff channel. Birth weight, term, age at surgery, sex, surgical approach, pathologi-
cal data and constipation score were not analyzed as risk factor for LUTS.
CONCLUSIONS
LUTS after HD are not uncommon and should be evaluated during follow-up. They could be due to
voiding disorders or a consequence of detrusor-sphincter dyssynergia. Surgical approach may not
be incriminated in LUTS prevalence. However a larger study is needed.