ESPU-Nurses Meeting on Friday 21, April 2023, 10:00 - 10:30
10:00 - 10:10
SN7-1 (OP)
Abhinay JOGULA, Rajendra NERLI, Nishant SETYA, Ashwin BOKARE and Ramana SRIPATHI
JN Medical College, KLE Academy of Higher Education and Research, Pediatric Urology, Belagavi, INDIA
PURPOSE
Management of renal injuries has progressively shifted towards a nonoperative approach. Blunt trauma accounts for 80% to 90% of all renal injuries. Most renal injuries are low-grade (American Association for the Surgery of Trauma [AAST] grades I and II), expectantly managed with observation, and have minimal morbidity. Even today nephrectomy remains a common intervention for high-grade renal trauma (HGRT).
MATERIAL AND METHODS
We prospectively gathered data on all children (≤18 years of age) patients presenting with high grade blunt renal trauma (grade IV & V). A centralized database platform was used for data collection. Computed tomography scan findings was used to grade the renal injuries.
RESULTS
A total of 78 children presented to our hospital with grade IV and V blunt renal injuries during the period Jan 2016 - Dec 2020. The overall mean age was 15.42±6.43 years and 64/78 (82.05%) patients were male. Fifty of the 78 patients had grade IV and the remaining 28 had grade V renal injuries. Thirty eight (48.71%) of the patients with HGRT had concomitant abdominal organ injuries. Forty (51.28%) of the 78 patients needed blood transfusions and 16 (20.5%) needed platelets transfusions within the first 24 hours following admission. Renal angiography with angioembolization was performed in 12 patients. Surgical exploration of abdomen was performed in 16 (20.5%) patients for renal injuries and/or other abdominal injuries . Nephrectomy was performed in 3 patients with grade IV and 6 patients with grade V injuries .
CONCLUSIONS
Eighty percent of the children with grade IV & V can be managed safely and successfully with expectant/conservative management . Nearly 20% do require surgical exploration for renal or other abdominal causes and nephrectomy rate is still significant (11.53%). Renal vascular causes remain the most common reason for nephrectomy.
10:10 - 10:20
SN7-2 (OP)
Ellen RAES 1, Joke MERTENS 1, Evi NOPPE 1, Lola BLADT 2, Alexandra VERMANDEL 1, Gunther DE WIN 1 and Stefan DE WACHTER 3
1) University of Antwerp, Faculty of Medicine and Health Sciences, Wilrijk, BELGIUM - 2) University of Antwerp, Department of Product Development, Antwerpen, BELGIUM - 3) Antwerp University Hospital, Department of Urology, Edegem, BELGIUM
PURPOSE
For the assessment of the lower urinary tract, urinary flow measurement is the most accepted and most widely used method. Yet only little data are available on voiding patterns of children during their toilet-training.
MATERIAL AND METHODS
In this observational study (n=) 6 children (age 28 - 32 months) who were about to start toilet training were recruited. All parents received a potty connected to a Minze homeflow® device and were asked to provide the potty to their children once elimination signals were observed. Fifteen measurements were recorded. At the end of toilet training, on average 3 months after the start, again 15 uroflows were recorded.
RESULTS
6 children participated at the start of their toilet-training. In 5 children bellshaped curves were already observed. In these, the median voided volume at the start of toilet training was 44 ml (range 19-74 ml).
4 of these children participated again after an average of 3 months. In this short period after the start of toilet training, median voided volumes increased from 44 ml to 49 ml (range 33 - 118 ml).
CONCLUSIONS
From the very beginning of toilet-training (youngest aged 28 months), uroflow patterns are already bell shaped.
10:20 - 10:30
SN7-3 (OP)
Josefin NORDENSTRÖM, Sofia SJÖSTRÖM and Michaela DELLENMARK BLOM
Queen Silvia Children's Hospital, Paediatric Urology, Göteborg, SWEDEN
PURPOSE
Countless of papers have been published regarding the clinical outcome of vesicoureteral reflux (VUR), however reports of the caretakers' experiences of VUR management are lacking. VUR management is still debatable since no active treatment has been proven superior to another, regarding preserving renal function. Therefore, qualitative research is needed to understand the parents' perspectives. This study aims to describe the parents' experiences of infant high-grade vesicoureteral reflux(hVUR).
MATERIAL AND METHODS
In this prospective study, four randomized, semi-structured focus groups (a method of collecting qualitative data) with 19 parents to 15 children (aged 1,5-6 years) were conducted. All children had been diagnosed with hVUR <6 months of age. Discussions were recorded, transcribed and analysed to content. The sample size for the FGs was based on category saturation, which was confirmed through comparison analysis in multiple FGs.
RESULTS
The focus groups generated 2900 parent-reported experiences regarding management, treatment and outcome. Negative experiences regarding the use of antibiotic prophylaxis (CAP), such as stress regarding the daily intake and worries about long-term use and side effects, were abundant. The experiences regarding surgical intervention (SI) were negatively affected by inadequate information and postoperative difficulties and positively by empathy, accurate information and adequate preparations. The increased risk of UTI:s were described as a constant emotional stress causing restricted social activities, frequent visits to the hospital and challenges regarding urine-sampling. There was a common awareness of renal damage, but few experiences reflected any actual worry.
CONCLUSIONS
This study shows that CAP and the risk of UTI have non-negligible, everyday impact on family life, while renal damage seems of secondary importance. The concerns of SI are related to an isolated occasion which can be optimized with proper care. Awareness of parents' experiences and preferences helps to tailor individual treatment.