ESPU Congress 2018 - Abstract Book

133 11–14 APRIL, 2018, HELSINKI, FINLAND 14:30–14:33 S17-3 (PP) PUBIC SYMPHYSIS APPROXIMATION DURING BLADDER EXSTROPHY CLOSURE WITH ABSORBABLE VS NON ABSORBABLE SUTURE Sarah BRAUNGART, David KEENE, Anju GOYAL, Tamas CSERNI and Raimondo CERVELLIONE Royal Manchester Children's Hospital, Paediatric Urology, Manchester, UNITED KINGDOM PURPOSE Traditionally, non-absorbable suture has been used to approximate the pubic symphysis during bladder exstrophy closure (BEC); erosion of suture through the urethra/bladder neck being a well- known complication. The authors compared success and complications of BEC using absorbable vs non-absorbable suture for pubic symphysis approximation. MATERIAL AND METHODS Data was prospectively collected on consecutive exstrophy patients treated in one single institu- tion between 2013 and 2017. Data measured included: age at surgery, pubic diastasis, use of osteotomy, type of pelvic immobilisation, success of closure, postoperative complications including need for intrapubic suture removal at follow-up cystoscopy. Two groups were identified: A) use of non-absorbable suture for pubic symphysis approximation, B) use of absorbable suture. Outcomes were compared with Fisher's test (categorical data), t-test (continuous data), a p-value of <0.05 was considered significant. RESULTS Fourty patients underwent BEC, 24 (4 female) in group A and 16 (9 female) in group B. Median age at BEC was 6.8 months (IQR5.5–7.2) in group A and 7.6 months (IQR5.5–8.8) in group B (p=0.2). Median pubic diastasis was 4.6 cm (4.4–5.1) in group A and 4.5 cm (4.0–5.4) in group B (p=0.8). All patients received pelvic osteotomies with external pelvic fixation. All patients had a successful BEC. In group A, 38 % of patients were found to have the intrapubic stitch migrated into urethra/ bladder neck at follow-up cystoscopy. 3 of these patients required excision of granuloma or stones that had formed around the suture. No intrapubic stitch was found at follow-up cystoscopy in group B (p=0.006). CONCLUSIONS Use of absorbable intrapubic sutures at time of BEC in the authors' hands does not affect success of closure but prevents the morbidity associated with stitch erosion. 14:33–14:42 Discussion