ESPU Congress 2018 - Abstract Book

136 29 th CONGRESS OF THE ESPU 14:50–14:53 S17-6 (PP) INGUINAL HERNIA WITH BLADDER EXSTROPHY (BE): MULTICENTRIC EXPERIENCE Alfredo BERRETTINI  1 , Paolo CAIONE  2 , Gianantonio MANZONI  1 , Laura DEL PRETE  2 and Marco CASTAGNETTI  3 1) Ospedale Maggiore Policlinico, Fondazione Cà Granda, Paediatric Urology Unit, Milan, ITALY - 2) "Bambino Gesù" Children's Hospital, Research Institute, Division of Pediatric Urology, Dept. of Surgery, Rome, ITALY - 3) University Hospital of Padua, Section for Paediatric Urology, Padua, ITALY PURPOSE Inguinal hernias are common in BE patients but there is no consensus on the ideal “timing” and surgical strategy for its repair and whether repair during initial bladder closure (IBC) might prevent risk of complications related to the hernia later in life. Multicentric experience in three tertiary centers is reported. MATERIAL AND METHODS We retrospectively reviewed data of 36 patients (30 male-83 %) who underwent primary BE repair from 2009–2016. Patients who had undergone initial surgery at other centers were excluded. RESULTS Hernia was repaired during IBC in 9/36 (25 %) patients at a median age of 47 (0–598) days. A pre- peritoneal approach was used in 7/9 (77 %) patients, a canalicular or sub-canalicular approach in 1 patient each respectively. One patient developed unilateral testicular atrophy after bilateral sub-canalicular approach. 13/36 (36 %) patients underwent a delayed hernia repair at a median age of 475 (16–1107) days including 11 undergoing an inguinal repair and 2 a laparoscopic ap- proach. In 14 cases, including all the 6 females, initial hernia repair was not performed. Of these, 4/8 males (50 %) needed urgent surgical exploration for incarceration at a median 174 (45–329) days from IBC. In none of the patients, a hernia recurrence was observed after a follow-up of 42 months(13–117). CONCLUSIONS Hernia repair during IBC is an effective option and a preperitoneal approach is safe. We observed 1 testicular atrophy after one inguinal hernia repair. Delayed surgery is feasible but further in- creases the number of surgeries and the risk of hernia incarceration is high in the untreated males. Recurrence risk is low in all of patients. N. Gender/ Median Age (days) Surgical approach Complications Incarceration (N) Recurrence Surgical management Contestual repair 9 9 M/12,4 6 Preperitoneal No 2 inguinal 1 Unilat testicular atrophy 1 (controlateral side) No 1 mixed Delayed 13 13 M/475 11 inguinal 2 laparoscopic No No hernia 14 8 M 4 (50 %) No 6 F No