ESPU Congress 2018 - Abstract Book

176

CONGRESS OF THE ESPU

11:32–11:35

S23-6 (PP)

ENDOSCOPIC INJECTION OF BULKING AGENT AROUND

THE EJACULATORY DUCTS AT THE VERU MONTANUM FOR

RECURRENT PEDIATRIC EPIDIDYMITIS

Alice FAURE, Mirna HADDAD, Thierry MERROT and Jean-Michel GUYS

Hopital La Timone Enfant, Pediatric surgery, Marseille, FRANCE

PURPOSE

Pediatric recurrent epididymitis is frequently observed in several urogenital conditions and may

result in long-term fertility deterioration. For the pediatric urologist, the management of recurrent

epididymitis is still a therapeutic challenge and there is no consensus. The current discussion for

management of recurrent epididymitis is mainly based on vas clipping. We present a minimally

invasive endoscopic approach for the treatment of recurrent epididymitis (>3 episodes).

MATERIAL AND METHODS

A retrospective case series was performed reviewing the medical records of 11 boys (8 months to

14.7 years old) who were referred with a history of recurrent epididymitis in a context of urogenital

malformations. All children underwent endoscopic transurethral injection. Dextranomer/hyaluronic

acid was injected around the ejaculatory ducts at the verumontanum. The medical records and

outcomes of the patients were retrospectively reviewed.

RESULTS

Of the 11 boys, 2 (18 %) had a history of bladder exstrophy, 3 (27 %) anorectal malformation,

2 (18 %) peno-scrotal hypospadias, 2 (18 %) posterior urethral valves, 1 (9 %) seminal vesicle

cyst and 1 (9 %) urethral stricture. Median age at injection was 3.75years (8 months to 14.7years).

Endoscopic injection did effectively prevent recurrence in 73 % of patients (8/11) with a median

follow-up of 3 years (ranged 6 months-8.8 years). Mean injected volume was 0.7 ml/session. No

perioperative complications were recorded. Vas clipping was performed in 3 patients after unsuc-

cessful injections.

CONCLUSIONS

Endoscopic injection of bulking agent in the verumontanum may be considered a safe and effective

treatment in 73 % of children with recurrent epididymitis.

11:35–11:44

Discussion