ESPU Congress 2018 - Abstract Book

148 29 th CONGRESS OF THE ESPU 16:26–16:29 S19-7 (PP) PROGRESSION OF THE CYSTOGRAM APPEARANCE OF PUV BLADDERS Ewan BROWNLEE, Ruth WRAGG, Harish CHANDRAN, Andrew ROBB and Liam MCCARTHY Birmingham Children's Hospital, Department of Paediatric Urology, Birmingham, UNITED KINGDOM PURPOSE Cystogram appearance of obstruction in PUV bladders is well recognized, but what happens to this after relief of obstruction? Is this predictive of outcome? We aimed to quantify bladder appearance (using the published SWRD score) prior to initial treatment, then at 6 years age, and correlate this with need for subsequent intervention. MATERIAL AND METHODS Boys were identified from a PUV clinic: date of birth, date of initial and subsequent imaging were recorded. Date(s) of later interventions (after initial valve incision), were recorded. Initial and 6-year follow-up appearance were quantified by SWRD score, bladder neck (BN) appearance, VUR were recorded. 3 blinded observers scored bladders, scores averaged. Data was median (interquartile range), analysis by Spearman Correlation, Wilcoxon matched-pairs test, Mann-Whitney U-test, Fisher exact test, P<0.05 taken as significant. SWRD Score 0 1 2 Shape Normal Irregular Grossly Distorted Wall Normal Trabeculated Grossly Trabeculated Reflux None Non-dilating Dilating Diverticulum Absent Present Niyogi et al, Journal Pediatric Urology; 2017: 13(3), 265.e1-e6 RESULTS 24 boys had initial and follow-up cystograms available. Age at initial cystogram and follow-up was 8(4–45) days, and 6.4(5.1–7.0) years. Later intervention was needed in 9 (Mitrofanoff pro- cedure). Appearance improved from initial cystogram to follow-up, SWRD score 3.3(2.1–5.0) vs. 0.8(0.1–1.0), P<0.0001. VUR improved significantly, 0.67(0–2) to 0(0–0), P<0.001. 13 BN were open initially, all closed at follow-up, P<0.0001. Initial cystogram appearance was no different in those requiring later intervention vs. no intervention, 3.3(2.3–5.0) vs. 3.0(1.7–5.7), P=0.8. However, follow-up appearance was significantly different, 1.0(0.8–3.3) vs. 0.3(0–1.3) respectively, P<0.01. CONCLUSIONS This report quantified the change in cystogram appearance in PUV bladders: Bladder appearance improved, open bladder necks closed, VUR improved. Early cystogram appearance didn’t correlate with late deterioration, but follow-up appearance did.