ESPU Congress 2018 - Abstract Book

188 29 th CONGRESS OF THE ESPU 12:53–12:56 S26-2 (PP) OUTCOMES OF ORTHOTOPIC PAEDIATRIC NEOBLADDER RECONSTRUCTION Alexander CHO, Naima SMEULDERS, Divyesh DESAI, Imran MUSHTAQ, Abraham CHERIAN and Peter CUCKOW Great Ormond Street Hospital, Paediatric Urology, London, UNITED KINGDOM PURPOSE In the rare situation where native-bladder is unavailable, creation of a neobladder using a composite of different bowel segments is an option. We present our experience and outcomes with these patients. MATERIAL AND METHODS Retrospective cohort-study of paediatric-patients undergoing orthotopic neobladder reconstruction (1998–2016). Statistical-Analysis: Wilcoxon Signed-Rank Test. RESULTS 18-patients (9F:9M); Median-age at reconstruction: 78(27–205) months. Background: • Complex cloaca with very small remnant/absent bladder x6 • Rhabdomyosarcoma:Bladder/Prostate x10; Pelvic x1 • Pre-sacral neuroblastoma x1 Operative-Notes: Segment 1 “Bladder-Plate” Segment 2 Numbers Sigmoid Distal-Ileum 6 Ileal-Caecum-Ascending Colon n/a 2 Ileal-Conduit (8) Transverse-Colon 1 Sigmoid-Colon & Ileum 3 Distal-Ileum 3 Sigmoid-Colon 1 Colonic-Conduit Mid-Ileum 1 Gastric-Segment Distal-Ileum 1 Mitrofanoff Creation: Appendix 13 (2x in-situ); Ileal-Monti 4; Jejunal-Monti 1 Median stay (days): 11(7–70) Significant adhesions found intra-operatively x7 Peri-Operative Complications: • 2x: UTI-sepsis • 1x Bladder-leak requiring re-operation with subsequent enterocutaneous-fistula requiring re‑operation & prolonged TPN Outcomes: - Median follow-up(months): 57 (9–215) - Upper-Tracts: Normal x8; Stable x10 - Renal Function: Stable (W-value 9.5, <3 significant). Median GFR pre-op=94, post-op=115. - Perforation / Secondary Malignancy / Malabsorption – Nil episodes - Continence: • Daytime: All dry - 16 pts CIC 3hrly in daytime; 2 patient CIC 3-4x/day