ESPU Congress 2018 - Abstract Book

236 29 th CONGRESS OF THE ESPU MATERIAL AND METHODS Since 2010, 65 patients (38 girls, 27 boys ) underwent surgery of fetal repair of MMC at the University Children's Hospital Zurich. 72 % (n=47) of the families are from all over Europe (Germany, France, Russia, Austria, Italy, Sweden, Slovakia, UK). These children are closely monitored at the special- ized multidisciplinary MMC centre and show several physical benefits e.g., motor function. However, about 2/3 of the patients present a neurogenic bladder dysfunction and the continence team is challenged by these new group of patients. RESULTS A summary of the challenges and opportunities in the continence care for a paediatric continence nurse specialist will be presented e.g., CIC support in different countries with different standards or being confronted with parent's expectations after surgery. CONCLUSIONS The fetal repair of MMC offers an opportunity to improve patient's health conditions, and enhance the vision of treatment for health providers. However, the new treatment and its different impact on physical function requires continuous attendance and medical as well as emotional support for the families. 10:30–10:40 S5-5 (LO) SIMPLE RECTAL ENEMA ALONE IS NOT SUFFICIENT FOR URODYNAMIC STUDIES IN SPINA BIFIDA PATIENTS Ezgi ALTUN TANIL  1 , Sibel TIRYAKI  2 , Ibrahim ULMAN  1 and Ali AVANOGLU  1 1) Ege University, Pediatric Surgery Division of Pediatric Urology, Izmir, TURKEY - 2) Ege University-Faculty of Medicine, Department of Pediatric Surgery, Division of Pediatric Urology, Izmir, TURKEY PURPOSE A simple rectal enema can often provide adequate emptiness of rectum to evaluate intraabdominal pressure in most cases. However, it may not be effective in patients with spina bifida who have severe constipation. The aim of this study was to compare different approaches to provide rectal emptiness for urodynamic tests in spina bifida patients. MATERIAL AND METHODS After ethical approval, we prospectively recorded the findings of urodynamics in spina bifida pa- tients. We performed urodynamic studies after a single rectal enema from March 2016 to March 2017 and after a three day rectal wash-out from March 2017 to September 2017. Two groups were compared in terms of failure to complete the study. RESULTS Urodynamic studies were performed in 164 spina bifida patients during the study period. There were 115 patients in the single enema and 49 patients in the three days wash-out group. There were no significant differences between the groups in terms of age (91 and 98 months respectively, p=0.722), sex (M/F:54/61 and 25/24, p=0.773), need for laxatives (24 % and 31 %, p=0.337) or incontinence (14 % and 22 %, p=0.260). The procedure was terminated due to the presence of stool in the rectum in none of the 49 patients in three days wash-out, but 29 of 115 (18 %) in the simple enema group (p<0.001). CONCLUSIONS A single rectal enema may be inadequate for completing a urodynamic study in spina bifida patients with severe constipation. A three-day intensive bowel cleansing warrants a successful study in most cases.