ESPU-Nurses Meeting on Friday 26, April 2019, 11:00 - 11:20
Babett JATZKOWSKI 1 and Gillian BARKER 2
1) Akademiska Barnsjukhuset Uppsala, Pediatric urology, Uppsala, SWEDEN - 2) Uppsala Akademiska Barnsjukhus, Pediatric urology, Uppsala, SWEDEN
We present a rare case of successful and complication free surgery on an adolescent girl with bladder exstrophy from Somalia. The patient did not receive any treatment in her home country and was kept hidden from others by her family. The family came to Sweden in 2014 as refugees.
PATIENT AND METHODS
A now 18 year old girl with bladder exstrophy from Somalia. The patient was uncircumcised, probably because of smaller defect in clitoris area, with normal labia. She underwent surgery for bladder exstrophy in 2014 at Uppsala University Hospital at the age of 14. Due to very small bladder capacity, the patient underwent bladder augmentation with a Mitrofanoff channel in 2015. She also suffered from cervix prolapse and received surgery (sacrospinosus fixation).
The now 18 year old girl lives a relatively normal life in Sweden. Although surgery was performed late, the patient has very few complications and a well functioning bladder without leakage. She attends school and has a normal social life.
Even though exstrophy surgery in Sweden is normally carried out in infancy at an age of 4 to 6 weeks, this report presents a case of successful surgery in a girl at 14 years of age with very few complications and excellent outcome.
The queen Silvia Children Hospital, Paediatric, Goteborg, SWEDEN
Physical activity is important for the health and well-being. But, exercise that stresses the pelvic floor muscles can lead to incontinence also in in young women, where stress incontinence otherwise is unusual. We want to highlight this in a case report.
A healthy 14-year-old girl is referred from the gynecology department. In the last two years, she has been suffering from urine incontinence in conjunction with gymnastics training. She also leaks during other physical effort. The problems increased when she started training with jump on the trampoline.
Gynecological examination and uroneurological status were normal. In repeated visits at the urotherapy unit the uroflowmetry and residual measurements were normal. Cystometry showed no signs of overactive bladder.
Micturition advises were given together with information about the function of the pelvic floor. Biofeedback was performed and instructions were given to continue exercise of the pelvic floor at home. Anticholinergics resulted in increased incontinence. Use of tampon gave minor effect. A vaginal aid was proposed, which reduced the incontinence to a certain extent. Referral was sent to a physiotherapist to continue pelvic floor training.
As it is not appropriate to operate young women with stress incontinence who has not given birth, we wish to start a discussion on how to best help young women with incontinence due to physical activities.