ESPU-Nurses Meeting on Friday 10, June 2022, 09:50 - 10:30
09:50 - 10:00
SN3-1 (OP)
Sara FAILY 1, Sumita CHHABRA 1 and Harriet CORBETT 2
1) Alder Hey Children's NHS Foundation Trust, Department of Surgery, Liverpool, UNITED KINGDOM - 2) Alder Hey Children's NHS Foundation Trust, Regional Department of Urology, Liverpool, UNITED KINGDOM
PURPOSE
Previous studies have identified that up to 20% of boys undergoing circumcision for Lichen Sclerosus (LS / BXO) require later meatal intervention. It has been suggested that meatotomy at the time of circumcision is protective. This study aims to determine factors associated with requirement for further meatal procedures post circumcision.
MATERIAL AND METHODS
Patients undergoing circumcision for histologically confirmed LS between January 2011 - February 2020 were identified, boys with hypospadias were excluded. Case notes were reviewed retrospectively to identify topical steroid use pre- and post-operatively, glans involvement and meatal procedure at time of circumcision and subsequent procedures.
RESULTS
382 boys underwent circumcision at a mean age of 9.1 years (SD 2.9 years). 8% underwent emergency circumcision following admission with acute urinary retention. Median follow-up was 4 months (IQR 3 - 11 months). Intra-operatively, the glans was affected by LS in 213/365 (58%) cases (not documented in 17). Of these, 224/365 (61%) were prescribed post-operative topical steroids. At the time of circumcision, 25 (7%) patients underwent meatotomy and 94 (25%) underwent meatal dilatation.
Following circumcision, 40 (10%) symptomatic patients required a median of 1 further procedure for meatal stenosis (range 1 to 5); 8 (2%) had dilatation alone. 32 (8%) required meatotomy, of whom 14 had had a meatal intervention at the time of circumcision (5 meatotomy, 9 dilatation). Using multiple logistic regression analysis, initial meatotomy and / or dilatation and prescription of post-op steroids were significantly associated with requirement for any post-circumcision meatal intervention (p<0.05). Meatotomy at the time of circumcision (but not meatal dilatation) and prescription of post-op steroids were significantly associated with undergoing a further meatotomy (p<0.05).
CONCLUSIONS
Neither meatal intervention at the time of circumcision nor post operative topical steroids seem to protect against subsequent symptomatic meatal pathology. Prospective studies are required identify optimal management of the meatus in boys with LS.
10:00 - 10:10
SN3-2 (OP)
Francisco De Borja NAVA Y HURTADO DE SARACCHO 1, Detlef OLIU 2, Virginia AMESTY MORELLO 3, Susana RIVAS VILA 3, Roberto LOBATO ROMERA 3, Maria Jose MARTINEZ URRUTUA 3 and Pedro LOPEZ PEREIRA 3
1) Childrens' Hospital La Paz, Pardiatric Urology, Madrid, SPAIN - 2) Complejo Hospitalario Universitario de Badajoz, Pediatric Surgery, Badajoz, SPAIN - 3) Hospital Universitario La Paz, Paediatric Urology, Madrid, SPAIN
PURPOSE
Non-ischaemic priapism (NIP) is a partial erection lasting ≥ four hours due to unregulated cavernous inflow following formation of an arteriolar-sinusoidal fistula. Supraselective arterial embolization (SAE) is the treatment of choice in the pediatric population. No information has been published about long-term results in this population. We present our outcomes in seven patients in a twenty-year period time.
MATERIAL AND METHODS
Retrospective study of patients diagnosed with NIP between 2001-2021. Medical and radiological information were analysed. Erectile function was determined using the International Index of Erectile Function short-from (IIEF-5) in patients older than sixteen years old and a questionnaire about the characteristics of physiological erections to the parents for the rest at follow-up.
RESULTS
Mean age at diagnosis was 6,5 years (0,58 – 11) from a total of seven. Four patients had a clear traumatic ethiology and three patients had a normal colour-doppler ultrasound (CDU). All patients underwent embolization due to unresponsiveness to conservative approach. Three patients have a normal sexual function according to IIEF-5 with a mean result of 22,3. The remaining patients have normal day-night erections with a flaccid penis in between. No recurrences were reported.
CONCLUSIONS
NIP is associated with an arteriolar-sinusoidal fistula and in certain cases, the causative factor remains unknow. CDU allows to verify the preservation of blood flow and to locate possible fistulas, but this is not always possible. We demonstrated that SAE is a safe approach without long-term complications.
10:10 - 10:20
SN3-3 (OP)
Maria Teresa ALONSO TORRES, Muñoz Perez MARIA, Gemma FERNÁNDEZ MALDONADO, Marta BARROSO BERGADÀ and Sandra PÉREZ SANCHO
Fundacion Puigvert, Nursing, Barcelona, SPAIN
PURPOSE
The urolithiasis is the result of a complex interaction between anatomic and metabolic conditions. The Nursing Attention Process is a systematic and organized method to manage individualized nursing care, to identify altered needs, perform interventions and evaluate them. This study aimed to describe a clinical case in 1 year old infant with renal stones.
MATERIAL AND METHODS
A case study. Infant, male sex, 1 year old age with bilateral kidney stones (premature: 29 weeks) with calcificated Double J catheter, and 9 Kg weight. Priority needs were identified through the 11 functional patterns of Marjory Gordon. An individualized care plan was designed and aimed to the maintenance of the urinary patterns. NANDA, NIC and NOC taxonomies were used.
RESULTS
The infant had 2 hospitalization stays. Total number of bed days used 32 days. The mean hospital stay was 16 days (10-22 days). Surgeries performed: 2 sedations Extracorporeal Shock Wave Lithotripsy, 1 calcificated Double J catheter removal, 1 sedation urethrocystoscopy, 1 bladder catheterization with sedation, renal colic. During postoperative presented symptoms like: pain, urinary tract infection, anuria, acute urine retention, prestlessness/vomiting, persistent fever, and crying. In addition, the parents showed perceptions and experiences like treatment rejection, no therapeutic adherence, fear and, discomfort and coping strategies when caring for child receiving paediatric care.
CONCLUSIONS
The role of the nurse in the application of an individualized care plan in the paediatric infant with kidney stones and the control of the signs and symptoms allowed the early detection of subsequent complications and promoted the satisfactory progress of the case
10:20 - 10:30
SN3-4 (OP)
Maria Teresa ALONSO TORRES, Sandra PÉREZ SANCHO, Marta BARROSO BERGADÀ, Gemma FERNÁNDEZ MALDONADO and Maria MUÑOZ PÉREZ
Fundacion Puigvert, Nursing, Barcelona, SPAIN
PURPOSE
The first choice treatment for infant affected with urolithiasis is the Extracorporeal Shock Wave Lithotripsy (ESWL), a non-invasive therapy. However, there are other treatment options. The present study aims to describe the Nursing Care Process in renal urolithiasis as well as to learn the sociodemographic characteristics of the patients an Uropaediatrics Unit of a third level hospital.
MATERIAL AND METHODS
A descriptive, retrospective, and Unicentric study. All uropaediatric patients ≤2 years old who attended a Center (Spain) from 1998 until 2019 were included in the study, a total 140 infant
RESULTS
The mean age of the studied cases was 1.77 years, 64.29% males and 35.71% females. 65% of the cases were ESWL and 35% other treatments. Number of episodes total were 184, 63.58% ESWL and 36.41% other treatments. In a case, the same patient was admitted up to 7 times (2 ESWL y 5 other treatments). The development of this study is based on the nursing care based on the theory of Majory Gordon, with which the restoration of the patient's health is achieved. Professionals maked a nursing care plan tailored to the needs of patients and families, including active listening, emotional support, therapeutic education, and information when hospital discharged
CONCLUSIONS
A Nursing Care process based in individualized attention helps improve the quality of care and prevent complications from hospitalization.