ICCS & ESPU-Nurses Meeting on Thursday 4, September 2025, 09:14 - 09:50
09:14 - 09:20
SN05-1 (OP)
Tariq BURKI, Iivy BITERANTA, Amr HODHOD, Yasser JAMALALAIL, Fayez AL-MODHEN, Ahlam SHAHRANI and Ahmed ALSHAMMARI
King Abdullah Specialized Children Hospital, NGHA, Riyadh, KSA, Department of pediatric urology, Riyadh, SAUDI ARABIA
PURPOSE
Urodynamic studies (UDS) are one of the important tools in pediatric urology. It is mostly done as an outpatient procedure. The administration of antibiotics prior to/during UDS is debatable and is typically given according to physician preference or institutional protocols. In this study, we evaluated the occurrence of Urinary tract infection in patients who underwent UDS comparing those who received antibiotic prophylaxis (AP)and those who did not.
MATERIAL AND METHODS
We retrospectively reviewed charts of patients who underwent UDS from 2017 to 2023. Patients' demographics were collected. We recorded the bladder status (neurogenic or non-neurogenic) and the presence of vesicoureteral reflux (VUR). Moreover, the presence of constipation and being on clean intermittent catheterization were documented. UTI was identified as fever >39 c with pyuria and the isolation of a single pathogen at a concentration > 50,000 CFU/ mL in a urine culture.
RESULTS
We collected 55 patients; 16 received AP, and 39 did not. Regarding the AP group, 11 patients (68.8%) were on sulfamethoxazole-trimethoprim, and the remaining were on nitrofurantoin. There was no significant difference between both groups in terms of gender, bladder status, being on CIC and presence of constipation. Three-fourths of AP patients had VUR compared to the other group (p=<0.001). UTI was diagnosed in one patient in each group (p=o.51). UTI was caused by non-E.coli organisms. Both patients had neurogenic bladder and were on CIC; however, neither had VUR. The one in the AP group was on nitrofurantoin prophylaxis.
CONCLUSIONS
The incidence of UTI following UDS is relatively low. The role of AP is limited in preventing procedure-related UTI if a strict aseptic technique is adopted. Despite the higher number of VUR patients in AP group, both patients with UTI were not refluxing.
09:20 - 09:26
SN05-2 (OP)
Bieke SAMIJN 1, Eline DESIMPELAERE 2, Peter PRINZIE 3, Els ORTIBUS 4, Bart SOENENS 3 and Sarah DE PAUW 2
1) Ghent University Hospital, Department of Human structure and repair, Department of Rehabilitation Sciences, Department of Urology, Ghent, BELGIUM - 2) Ghent University, Department of Special needs education, Ghent, BELGIUM - 3) Ghent University, Department of Developmental, personality and social psychology, Ghent, BELGIUM - 4) University Hospital Leuven, Department of Child Neurology, Leuven, BELGIUM
PURPOSE
Addressing parental stress is important to improve long-term outcomes for parents and children. The current research evaluates the influence of continence on parental wellbeing in parents of children with cerebral palsy (CP).
MATERIAL AND METHODS
Results are part of a larger study investigating the impact of CP on parental stress. Parents of children with CP completed a survey based on validated questionnaires, including the basic psychological need satisfaction and frustration scale, the parental stress scale and parental burnout assessment. Continence for stool and urine was evaluated by means of diaper use and accidents without the need for diaper use. Data was collected from 111 parents/guardians of children with CP.
RESULTS
When comparing groups, parents of children that were completely continent for stool demonstrated lower parental stress (p = 0.02) and felt more autonomous (p = 0.01) and more connected to significant others (p < 0.001). Despite lower parental stress in the presence of complete urinary continence, no statistically significant differences were seen (p > 0.1). Having accidents without the need for diaper use already demonstrated statistically significant lower scores on basic parental needs and higher parental stress, but low number of children with small accidents prohibit generalization of these findings.
Regression analysis demonstrated stool continence as a significant predictor of lower parental stress (p = 0.02) and higher satisfaction of parental needs (p = 0.002).
CONCLUSIONS
Incontinence can increase perceived stress in parents of children with CP. Specifically the presence of stool continence has an impact on parental wellbeing.
09:26 - 09:32
SN05-3 (OP)
Michael FRUMER, Tal MAY, Roy MORAG, Yulia TAL, Anna BABAOFF, Dmitry KHUNOVICH and David BEN-MEIR
Schneider Children's Medical Center, Urology, Petach Tikva, ISRAEL
PURPOSE
To describe a user-friendly voiding monitoring method based on a bedwetting alarm and evaluate its clinical significance in assessing lower urinary tract function.
MATERIAL AND METHODS
Data were collected from children with outpatient bedwetting alarm assessments at our institution (2021-2025). Assessments involved placing an alarm on a new diaper. Upon alarm activation, the diaper was weighed, and a post-void ultrasound residual was checked. The diaper was then replaced with a new alarm.
The number and volume of voids, time intervals between voids, leaks, and post-void residuals were recorded.
RESULTS
35 children with a median age of 2 years (IQR 1, 3.4) were included. 15 were girls (43%), 26 (74%) had neurogenic bladders, 3 (9%) had undergone bladder surgery, 3 had only reflux, and 2 (6%) had non-neurogenic functional disorders.
Reasons for the assessment included: Decision-making regarding clean intermittent catheterization (CIC) in 22 children (63%) who had undergone unsatisfactory urodynamic study, assessment of emptying after bladder\reflux surgery in 5 (14%) children, evaluation of the necessary frequency of CIC in 4 (11%) children, and suspicion of bowel-bladder dysfunction in 4 children.
The median test duration was 4.5 hours (IQR 4, 5). Based on the findings, CIC was initiated in 11 children (31%) [all with neurogenic bladders] and discontinued in 3 children (9%) [all non-neurogenic]. In 12 children (34%), normal findings ruled out the need for further investigation. Focusing on the subgroup of 20 children with neurogenic bladders who underwent a complementary bedwetting alarm test after urodynamic, CIC was initiated in 11 (55%).
CONCLUSIONS
Outpatient bedwetting alarm assessment is a complementary test that can aid in making treatment decisions in non-toilet-trained children, and in children with neurogenic bladder. Based on these findings, this test has been incorporated into the practice of our unit.
09:32 - 09:38
SN05-4 (OP)
Michela GALATI 1, Ida BARRETTA 2, Claudio PARATORE 2, Noemi DEANESI 2, Chiara PELLEGRINO 2, Antonio ZACCARA 2, Marialuisa CAPITANUCCI 2, Rebecca PULVIRENTI 2, Martina PENNESE 2, Gaia BRUNETTI 2, Tiziana SERANI 2, Giada GERVASI 2, Tiziana LORETI 2 and Giovanni MOSIELLO 3
1) Bambino Gesù Children's Hospital- Rome, Surgery for Continence and Neuro-Urology, Rome, ITALY - 2) Bambino Gesù Children's Hospital- Palidoro/Rome, Surgery for Continence and Neuro-Urology, Rome, ITALY - 3) Bambino Gesù Pediatric Hospital, Surgery , Division of Neuro-Urology, Rome, ITALY
PURPOSE
Clean intermittent catheterization (CIC) is a mainstay in the management of neurogenic bladder-sphincter dysfunction (NBSD). CIC may not always be tolerated or feasible and in these cases urinary derivation may be required. We implemented percutaneous button cystostomy (PBC) technique, previously described, to maximize applicability and minimize conversion rate. Aim of this study is to evaluate its feasibility and effectiveness in the pediatric population.
MATERIAL AND METHODS
All patients treated with PBC between 2020-2024 were retrospectively evaluated. Outcomes were evaluated considering conversion and complication rate, patient-reported tolerance to the device, and effectiveness in bladder management. statistical analysis with SPSS Microsoft.
RESULTS
50 patients (32 males) with a median age of 7.9(4.6-13.3) years were included. 5/50 were <1year-of-age. Indications for PBC placement were spinal dysraphism (N=36), central neurological impairment (N=7), posterior urethral valves (PUV, N=4), severe bilateral reflux (VUR, N=2) and epispadias (N=1). No conversion to open surgery nor intraoperative complications were reported. Mean operative time was 45(4.3) minutes. During a mean follow-up period of 22.9(17) months, 9 complications were reported, including device dislocation(1), non-febrile UTI(6), and peristomal leakage(2). No complications occurred in all patients ≤1year-of-age. 46/50 patients reported optimal device tolerance and clinical effectiveness, while 4 non-responders required a different bladder drainage (Mitrofanoff).
CONCLUSIONS
Based on these results, our modified PBC technique seems to be feasible and effective throughout all ages and conditions, minimizing the conversion rate. Our PBC technique seems applicable and promising also in newborns and infants with PUV and severe VUR. Further comparative studies are needed to confirm this approach in these patients.
09:38 - 09:44
SN05-5 (OP)
Seung Hyeon YANG 1, Eun Kyung CHOI 2, Hyeseon YUN 2, Hooyun LEE 2 and Kyua KIM 2
1) Gachon University, College of Nursing, Incheon, REPUBLIC OF KOREA - 2) Yonsei University, College of Nursing, Seoul, REPUBLIC OF KOREA
PURPOSE
Spina bifida (SB) is a chronic condition requiring lifelong management (Iskandar & Finnell. NEJM 2022; 387: 444–50). Clinical characteristics such as urinary or fecal incontinence, and transition readiness impact the quality of life (QOL) of children with SB (Sawin et al., DHJ 2021; 14: 100940). Parents of children with SB report elevated levels of parenting stress, which is associated with reduced QOL (Sadighian et al., Urology 2021; 153: 339–44). However, the relationship between these factors remains unclear, hindering the development of effective interventions to enhance the QOL of children with SB. This study aims to provide a comprehensive examination of the impact on QOL of children with SB and their parents from a family and clinical characteristics perspective.
MATERIAL AND METHODS
This study was conducted in South Korea with 141 child-parent pairs. The children, aged 7–13, all had a diagnosis of spina bifida, including meningomyelocele, lipomeningomyelocele (LMMC), or tethered cord syndrome. Data were collected between October 2022 and July 2024 and analyzed using the Actor-Partner Interdependence Mediation Model.
RESULTS
Children with SB had a mean age of 9.33 years; 51.8% were boys, and 54.6% were diagnosed with LMMC. For children with SB-related clinical characteristics, child transition readiness was identified as a significant mediator between parenting stress and child QOL (estimate=-0.084). Additionally, family resilience was identified as a significant mediator between parenting stress and parental QOL (estimate=-0.131). No significant mediators were identified in the group without clinical characteristics.
CONCLUSIONS
This study found that transition readiness enhances the QOL for children with SB who have clinical characteristics, suggesting that existing transition guidelines should prioritize this group (Fremion et al., JPRM 2023; 16: 583–93). Additionally, the findings from children aged 7–13 provide strong evidence that transition education should begin earlier, as most previous studies have focused on adolescents.
09:44 - 09:50
SN05-6 (OP)
Yaser EL HOUT 1, Ananda NACIF NUNES 1, Jessica ARAG 1, Omar ALJARALLAH 2 and Santiago VALLASCIANI 1
1) Sidra Medicine, Surgery, Urology, Doha, QATAR - 2) Sidra Medicine, Surgery,Urology, Doha, QATAR
PURPOSE
CIC is a mainstay management in children with neurogenic bladder. Being at the forefront of healthcare, nurses are entrusted to perform and teach CIC. Nurses experience with CIC is not clear. We sought to explore nurses' knowledge, skills and involvement with CIC in a pediatrics tertiary care center.
MATERIAL AND METHODS
A 20-question survey was devised to include demographics, educational background, training experience including use of models, confidence in performing and teaching CIC and actual clinical performance of CIC in the previous year. The survey was administered to nurses attending the World Nurses Day social event in a pediatric tertiary care center.
RESULTS
37 nurses completed the questionnaire, 32 (86%) were females. Mean age was 37 yrs. (23-60 yrs.) with a mean of 14.5 yrs. (1-43 yrs.) of experience, coming from multinational background (8 countries of education). 84% had formal teaching about catheterization but 35% never practiced on a model. Knowledge rating about urological conditions when CIC is required was 16% very well, 57% somewhat and 27% very little. While 92% have ever inserted a catheter, only 5% did the insertion within 1 month or less and 81% have not inserted a catheter in 1 year or more. Only 11% considered the skill set needed to perform catheterization to be easy, 70% moderate and 19% difficult. 48% felt confident to perform CIC, 38% would do it with help and 14% were not confident. Only 32%felt confident to teach CIC to a child, 41% to a parent and 49% to a nurse. When asked if they needed more model-based training opportunity, 85% said yes.
CONCLUSIONS
This study demonstrates an alarming unmet gap in nurses' knowledge, skills and practice of CIC and calls for revisiting and improving currently available methods and approaches in acquiring and transmitting CIC skills among nurses.