ESPU-Nurses Meeting on Friday 21, April 2023, 08:50 - 09:30
Nao IGUCHI 1, M. İrfan DÖNMEZ 2, Anna MALYKHINA 1 and Duncan WILCOX 3
1) University of Colorado Denver, Surgery, Aurora, USA - 2) İstanbul University, Urology, İstanbul, TURKEY - 3) Children's Hospital Colorado, Surgery, Aurora, USA
The aim of this study was to investigate potential beneficial effects of tocotrienols which have been suggested to inhibit Hypoxia inducible factor (HIF) pathway, on partial bladder outlet obstruction (PBOO)-induced bladder pathology.
MATERIAL AND METHODS
PBOO was surgically created in juvenile male mice. Sham-operated mice served as the control. Each group of animals received daily oral administration of either tocotrienols (T3) or soybean oil (SBO, vehicle) from day 0 to 13 post-surgery. Bladder function was examinedin vivo by void spot assay. At 2 weeks post-surgery, the bladders were subjected to 1) physiological evaluation of detrusor contractilityin vitro using bladder strips, 2) histology by H&E staining and collagen imaging, and 3) gene expression analyses by qPCR.
A significant increase in the number of small voids was observed after 1 week of PBOO compared to the control groups. At 2 weeks post-surgery, PBOO+SBO mice showed a further increase in the number of small voids, which was not observed in PBOO+T3 group. PBOO-induced decrease in detrusor contractility was similar between two treatments. PBOO induced bladder hypertrophy to the same degree in both SBO and T3 treatment groups, however, fibrosis in the bladder was significantly less prominent in the T3 group than the SBO group (1.8- vs. 3.0-fold increase in collagen content compared to the control). Enhanced levels of HIF target genes in the bladders were observed in PBOO+SBO group, but not in PBOO+T3 group compared to the control.
Oral tocotrienol treatment reduced the progression of urinary frequency and bladder fibrosis by suppressing HIF pathways triggered by PBOO.
Ramana SRIPATHI, Rajendra NERLI, Abhinay JOGULA, Nishant SETYA and Ashwin BOKARE
JN Medical College, KLE Academy of Higher Education and Research, Pediatric Urology, Belagavi, INDIA
Posterior urethral valves (PUVs) are the most common cause of bladder outlet obstruction in infants. Elevated nadir serum creatinine is the only independent factor associated with renal failure in the long term. The objective of our study was to assess the long term outcome in children presenting late (≥6 months) and with serum creatinine ≤ 0.8 mg% compared to children presenting early and with raised serum creatinine.
MATERIAL AND METHODS
The outpatient and inpatient charts of all children undergoing fulguration of posterior urethral valves were retrospectively reviewed. Group I included children with PUV presenting to us ≥6 months after birth with a serum creatinine ≤0.8 mg% at presentation . Group II included children presenting within 6 months of birth and with serum creatinine >0.8 mg%. The presenting symptoms, serum creatinine following fulguration of valves, presence of VUR , presence of dysplastic renal units and post fulguration complications were noted . Only children with a minimum of 10 year follow-up were included in the study.
During the study period Jan 2001 till Dec 2010 a total of 16 children (group I) with a mean age of 17.56 ±4.38 months and a mean serum creatinine of 0.60±0.12 mg% presented with symptoms of post-void dribbling , urinary incontinence , poor flow and urinary tract infections. During the same period 44 other children (group II) with a mean age of 3.53±1.84 months and a mean serum creatinine 1.10±0.22 mg% underwent valve fulguration for PUV. Children in group I performed clinically better and only 2 (12.5%) children had end stage renal disease at a mean follow-up of 140 months as compared to 12 (27.2%) in group II.
Boys with PUV and who present later in life tend to have a more normal urinary tract. A small percentage of these children progress to ESRD compared to children who present early and with raised creatinine
Thomas LOUBERSAC, Maximilien BARON, Brigitte PERROUIN-VERBE, Bénédicte REISS, Chloe LEFEVRE, Jerome RIGAUD, Marc-David LECLAIR and Marie-Aimée PERROUIN-VERBE
CHU of Nantes, Nantes, FRANCE
To present the case of the 16 years girl who undergone a robot assisted laparoscopic Mitrofanoff out of series of 5 consecutives pediatrics cases and to report our surgical technic.
MATERIAL AND METHODS
Since 2017, we have performed Robotic Assisted Laparoscopic Continent Urinary Diversion(RALCUD), and all patients were prospectively included.
We report the case of a 16 years old female with a tetraplegia secondary to a spinal cord injury level C5 AIS B. She needed Clean Intermittent Catheterization(CIC), but she was not able to do it by herself. On the urodynamics, the bladder was well inactive by oxybutynin, the bladder capacity was of 500ml and there was no urine leakage during the filling. After a multidisciplinary evaluation, it was decided to perform a RALCUD of Mitrofanoff (Appendicovesicostomy) without bladder augmentation.
The tube was implanted in the posterior bladder wall, according to lich-Gregoire anti-reflux principle and the stoma was brought to the umbilical site.
The surgery lasted 221 min and blood loss were
At the 12 months, there was no leakage from the urethra neither the stoma nor there was no difficulty to catheterize the stoma with a 16 French catheter.
RALCUD of Mitrofanoff especially with neurogenic bladder seems safe and feasible. It provides short-term very high rate of stomal and urethral continence with a low rate of complications.
Ece Zeynep SAATÇI 1, Melis ÜNAL 1, Aygül KÖSEOĞLU 1, Tuğçe ATALAY 2 and Halil TUĞTEPE 3
1) Uropelvic Solutions Clinic, Pelvic Floor Rehabilitation, Ataşehi̇r, TURKEY - 2) Private Tugtepe Pediatric Urology Center, Pelvic Floor Rehabilitation, Ataşehi̇r, TURKEY - 3) Private Tugtepe Pediatric Urology Center, Ataşehi̇r, TURKEY
Functional constipation (FC) is a commonly seen gastrointestinal problem seen at childhood. Since 2016, Roma IV criteria is used to diagnose FC. Considering the strong relationship between health status and physical activity (PA) in the literature, it’s thought that a sedentary lifestyle of children during COVID-19 epidemic may have an effect on constipation. The aim of this study was to examine the relationship between the severity of symptoms and PA levels in children with FC.
MATERIAL AND METHODS
43 children diagnosed with FC according to the ROMA IV criteria and physical examination including rectal examination between May 2020 and June 2021 were included in the study. Age, gender, body mass index (BMI), regular PA presence, defecation frequency, symptom scores for bladder and bowel dysfunction were determined by the Childhood Bladder and Bowel Dysfunction Questionnaire (CBBDQ); PA levels were evaluated with “Physical Activity Questionnaire for Primary School Children(FAS)”.
The mean age of participants was 8.45±2.8 years, the mean weekly defecation number was 2.4±1.3 and the rectal diameter was 39.85±11.81mm. The mean FAS score was 19.53±4.42 and the mean CBBDQ score was 24.41±8.4. 44% of children with FC stated that they did perform PA while they were at home during COVID-19. The participants' bladder and bowel dysfunction severity was found to be correlated with PA levels, presence of regular PA and rectal diameter(rho=-0.337, p=0.027; rho=-0.456, p=0,002; rho=-0.370, p=0.015) but age, gender and BMI wasn’t found to be associated with the CBBDQ score (p>0.05).
Intestinal symptoms severity and PA level were found to be correlated. For the protection and regulation of intestinal health of children during the pandemic period, adequate PA and exercise opportunities should be provided. Further study with larger sample sizes and more objective methods needs to be planned.