ESPU Congress 2018 - Abstract Book

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190 29th CONGRESS OF THE ESPU
CONCLUSIONS
After a median follow-up of almost 16 years, 13–18 % of the patients developed an ureteroenteric
anastomotic stricture. As already known, the continent diversion has a risk of worsening the renal
function. Suprinsingly we found no worse outcome for those children that developed a stricture than
those without this complication.
These findings emphazise the need for lifelong and regular urological surveillance of these children.
Because if fastly treated, the appearance of ureteroenteric stenosis does not compellingly lead to
a worsened renal function.
12:59–13:08
Discussion
13:08–13:11
S26-4 (PP)
THE CAUSES AND CONTEXT OF BLADDER
REAUGMENTATION IN CLASSIC BLADDER EXSTROPHY
RECONSTRUCTION
Karl BENZ1, John JAYMAN1, Mahir MARUF1, Timothy BAUMGARTNER1 , Matthew
KASPRENSKI2 and John GEARHART1
1) Johns Hopkins Hospital, Charlotte Bloomberg Children's Hospital, Baltimore, MD, USA, Robert D. Jeffs Division
of Pediatric Urology, Baltimore, USA - 2) Johns Hopkins Hospital, Charlotte Bloomberg Children's Hospital, Baltimore,
MD, USA, Pediatric Urology, Baltimore, USA
PURPOSE
Following a successful primary closure in patients with classic bladder exstrophy (CBE), an aug-
mentation cystoplasty (AC) may be required if the bladder continues to have low capacity. Never
addressed in the literature to date, this study aims to characterize the causes of reaugmentation in
this unique population.
MATERIAL AND METHODS
A prospectively-maintained institutional database of 1311 exstrophy-epispadias complex patients
was reviewed for CBE patients who have undergone more than one AC procedure. Data regarding
bladder capacities and reason for reaugmentation were evaluated.
RESULTS
A total of 166 CBE patients underwent AC. Of these, 18 (11 %) patients underwent a reaugmenta-
tion. The median age at initial AC was 60 months [IQR 41–78]. The median age at reaugmentation
was 108 months [IQR 95–138]. The median time between the initial AC and reaugmentation was
55 months [IQR 39–82]. There were several indications for reaugmentation including continued
small bladder capacity (15/18), inadequate bladder necks (4/18), leaking stomas (3/18), a penile
fistula (1/18). The sigmoid colon was the most commonly used bowel segment in initial AC (7 pa-
tients), while the ileum was the most commonly used segment during reaugmentation (12 patients).
The median bladder capacity prior to reaugmentation was 150 mL (range 60–350 mL) and 550 mil-
liliters (range 150–950 mL) after reaugmentation.
CONCLUSIONS
The applications of bladder reaugmentation are rare in this subgroup of patients. Nevertheless, it is
most commonly required in the setting of a small bladder capacity after an initial AC. Small bladder
capacity after the initial AC is most commonly seen in bladders leaking urine after a bladder neck
procedure.