ESPU Congress 2018 - Abstract Book

176 29 th CONGRESS OF THE ESPU 11:32–11:35 S23-6 (PP) ENDOSCOPIC INJECTION OF BULKING AGENT AROUND THE EJACULATORY DUCTS AT THE VERU MONTANUM FOR RECURRENT PEDIATRIC EPIDIDYMITIS Alice FAURE, Mirna HADDAD, Thierry MERROT and Jean-Michel GUYS Hopital La Timone Enfant, Pediatric surgery, Marseille, FRANCE PURPOSE Pediatric recurrent epididymitis is frequently observed in several urogenital conditions and may result in long-term fertility deterioration. For the pediatric urologist, the management of recurrent epididymitis is still a therapeutic challenge and there is no consensus. The current discussion for management of recurrent epididymitis is mainly based on vas clipping. We present a minimally invasive endoscopic approach for the treatment of recurrent epididymitis (>3 episodes). MATERIAL AND METHODS A retrospective case series was performed reviewing the medical records of 11 boys (8 months to 14.7 years old) who were referred with a history of recurrent epididymitis in a context of urogenital malformations. All children underwent endoscopic transurethral injection. Dextranomer/hyaluronic acid was injected around the ejaculatory ducts at the verumontanum. The medical records and outcomes of the patients were retrospectively reviewed. RESULTS Of the 11 boys, 2 (18 %) had a history of bladder exstrophy, 3 (27 %) anorectal malformation, 2 (18 %) peno-scrotal hypospadias, 2 (18 %) posterior urethral valves, 1 (9 %) seminal vesicle cyst and 1 (9 %) urethral stricture. Median age at injection was 3.75years (8 months to 14.7years). Endoscopic injection did effectively prevent recurrence in 73 % of patients (8/11) with a median follow-up of 3 years (ranged 6 months-8.8 years). Mean injected volume was 0.7 ml/session. No perioperative complications were recorded. Vas clipping was performed in 3 patients after unsuc- cessful injections. CONCLUSIONS Endoscopic injection of bulking agent in the verumontanum may be considered a safe and effective treatment in 73 % of children with recurrent epididymitis. 11:35–11:44 Discussion