30th ESPU Congress - Lyon, France - 2019

S6: POSTERS SESSION

ESPU-Nurses Meeting on Friday 26, April 2019, 11:20 - 11:50


11:20 - 11:27
S6-1 (PP)

SHOULD UPPER LIP GRAFT (ULG) BE THE FIRST OPTION FOR REDO HYPOSPADIAS IN CHILDREN?

Tariq Osman ABBAS, A ELKADHI, Bruno LESLIE, Santiago VALLASCIANI and Joao PIPPI SALLE
Sidra Medicine, Urology, Doha, QATAR

PURPOSE

Buccal mucosa from Lower lip and cheek are commonly used for urethroplasty. In recent years, aiming to improve the donor site morbidity our preference has changed to the use of Upper Lip Graft (ULG). The aim of our study is to evaluate the oral outcomes of ULG.

MATERIAL AND METHODS

Prospectively non validated questionnaires were administered during clinic visits to parents of 24 patients who underwent ULG between January, 2016 and August, 2018 in order to assess the short and mid-term of ULG donor site outcomes. All grafts were taken from one side of the upper lip (sparing the frenulum), defatted and then applied over the recipient site with the standard technique. No specific oral antiseptics/analgesics were applied. Demographic data and morbidity of ULG harvest, including oral pain, sensation and intake and donor site contraction were assessed postoperatively.

RESULTS

Answers of 24 boys' families with a median age of 19 months (range 8-42) related to 25 ULG were analyzed with a mean followup of 14months. One patient had local pain for more than 12 hours. All others resumed normal diet within 48 hours. None developed perioral numbness, difficulty with mouth opening, contraction or abnormal salivation. Donor site showed full mucosal regeneration in all patients within 3 weeks and neither local contraction nor ulceration.

CONCLUSIONS

ULG harvest is well tolerated and most patients resume normal diet shortly after surgery. As no oral complications were observed and thin suitable grafts were obtained, we suggest ULG as a first option in cases of distal urethral complications.


11:27 - 11:34
S6-2 (PP)

POSTERIOR URETHRAL VALVES IN PATIENTS WITH TRISOMY 21: A FREQUENT ASSOCIATION WITH DIVERSE PRESENTATION

Harriet CORBETT 1, Charlotte KANE 2, Anna-May LONG 2 and Helen Fiona MCANDREW 1
1) Alder Hey Children's NHS Foundation Trust, Regional Department of Urology, Liverpool, UNITED KINGDOM - 2) Alder Hey Children's NHS Foundation Trust, Department of Surgery, Liverpool, UNITED KINGDOM

PURPOSE

The UK live-birth prevalence of Posterior Urethral Valves (PUV) was recently estimated at 2.84/10,000 boys with 35% detected antenatally. Between 1998 and 2013 the live-birth prevalence of Trisomy 21(T21) in England and Wales was 10.4/10,000 [95% CI: 10.2–10.6]. We review the incidence and presentation of T21 among our PUV population.

MATERIAL AND METHODS

Hospital coding data was used to identify boys with PUV and T21 presenting to a single institution between January 2000 and September 2018. Medical records were reviewed.

RESULTS

Of 186 boys with PUV, seven had T21, (3.8% [95% CI 1.5-7.6%]). Notes were unavailable for one. Two had antenatal hydronephrosis.  One of these had post-natal respiratory distress requiring ventilation and PUV was suspected from birth. The other had unilateral hydronephrosis and developed urosepsis at two-months leading to diagnosis of PUV. Four boys presented postnatally. One infant with congenital cardiac disease and IUGR required neonatal intensive care. PUV was diagnosed due to poor renal function at one week (creatinine >400). Three boys presented late; two with poor bladder function at seven and ten years and one with haematuria secondary to UTI at 15 years.

CONCLUSIONS

We note a high proportion of boys with PUV and T21 in our population. Their presentation is varied  and clinicians should consider early investigation for valves in boys with T21 who present with urinary tract symptoms.


11:34 - 11:41
S6-3 (PP)

EFFECTS OF A 2-STEP MOBILE APPLICATION PROGRAM ON SELF-MANAGEMENT AND QUALITY OF LIFE OF CHILDREN WITH SPINA BIFIDA

Eun Kyoung CHOI 1, Eunjeong BAE 2, Eunyoung JUNG 2, Yong Ju LEE 3, Yoonhye JI 4 and Sang Won HAN 5
1) Yonsei Univerity, College of Nursing, Seoul, REPUBLIC OF KOREA - 2) Yonsei University Graduate School, Department of Nursing, Seoul, REPUBLIC OF KOREA - 3) Hallym Univerisity, Kangnam Sacred Heart Hospital, Department of Pediatrics, Seoul, REPUBLIC OF KOREA - 4) Severance Children's Hospital, Yonsei University Health System, Department of Pediatric Urology, Seoul, REPUBLIC OF KOREA - 5) Yonsei University College of Medicine, Department of Urology and Urological Science Institute, Seoul, REPUBLIC OF KOREA

PURPOSE

Children with spina bifida (SB) who spend most of their time at school should be able to perform self-management behaviours independently. Mobile applications could be effectively used for that purpose. The aim of this study was to evaluate the effects of the mobile application program on self-management and health related quality of life (HRQOL) of children with SB.

MATERIAL AND METHODS

This quasi-experimental study was conducted on school-aged children with SB. Both experimental and control group (n=24) went through the half-day integrative educational program (IEP). The experimental group participated in the mobile application program which had been developed at our previous study, 4 weeks additionally. They were assessed at baseline and 1, 5, and 9 weeks after IEP completion. Outcomes were assessed through children's self-management behaviour and HRQOL estimated by their parents.

RESULTS

In the experimental group, 99.1% of the participants completed the 4-week mobile application program. Their satisfaction with mobile application was rated with 4, while 5 was the highest rank. Experimental and control groups had the same group assignments. Self-management behaviours and HRQOL were increased after intervention, interactions between groups and time did not differ significantly.

CONCLUSIONS

This was the first study that used combination of IEP and mobile application to foster self-management behaviours of children with SB. Adherence to the mobile application of the children was high for an intensive mHealth intervention. However, short-term effectiveness could not be demonstrated. Additional clinical trials are needed, which include large samples and examination of short-term and long-term effects.


11:41 - 11:48
S6-4 (PP)

A LOWER D2/D4 DIGIT RATIO AND SCROTAL BASE DISTANCE IN MALE INFANTS WITH HYPOSPADIAS AND/OR CRYPTORCHIDISM THAN NORMAL BOYS.

Tariq Osman ABBAS 1, A ELKADHI 2 and Joao PIPPI SALLE 3
1) Hamad General Hospital, Pediatric Surgery, Doha, QATAR - 2) Hamad Medical Corporation, Pediatric Surgery, Doha, QATAR - 3) Sidra Medicine, Urology, Doha, QATAR

PURPOSE

In humans, the ratio of the index finger to the ring finger is sexually dimorphic, as the mean ratio was found to be shorter in men than in women. It has been suggested that this difference is related to prenatal androgen exposure in men. This has been also demonstrated in children with severe hypospadias and congenital adrenal hyperplasia. We have shown previously that scrotal base distance is lower in patients with Hypospadias and undescended testes. We therefore aimed to determine if the 2D:4D digit ratio was correlating with scrotal base distance (SBD) in this group of patients.

MATERIAL AND METHODS

We prospectively enrolled prepubertal patients with cryptorchidism or hypospadias between September 2016 and January 2018. We then compared their D2:D4 digit ratio with SBD in two control groups made up of normal boys and with Hypospadias or undescended testes.

RESULTS

57 boys with hypospadias or cryptorchidism, 79 boys undergoing circumcision we included. The mean D2:D2 ratio for left hands was significantly different between the two groups, and correlating with SBD (p<0.05).

CONCLUSIONS

It appears that boys with cryptorchidism or hypospadias have a lower D2:D4 digit ratio than boys without genital anomalies. This ratio is correlating with the newly described genital anthropometric measure "scrotal base distance". This validate the utilization of this measure as an a physical reflection to male fetal underverilization.