ICCS & ESPU-Nurses Meeting on Thursday 4, September 2025, 09:55 - 10:16
09:55 - 09:58
SN06-1 (PP)
Molly PETRI, Courtney WINN, Christine DO, Jonathan OLAIS, Helal SYED, Callum LAVOIE, Brian CHUN, Edward DIAZ, Andy CHANG, Joan KO, Roger DE FILIPPO, Evalynn VASQUEZ and S. Scott SPARKS
Children's Hospital Los Angeles, Urology, Los Angeles, USA
PURPOSE
Hypospadias is a congenital birth defect affecting approximately 1 in 200 boys. Post-operative complications after hypospadias repair are common, and surgeons, nurses, and parents may interpret post-operative success differently. We aim to assess parental expectations and to compare clinician versus parental satisfaction related to hypospadias repair.
MATERIAL AND METHODS
We recruited 40 patients undergoing distal, one-stage hypospadias repair at our institution and their caregivers. Photographs were captured preoperatively, at the 1-3 month post-operative visit, and at the 1+ year follow-up visit. Nurse Assessments were conducted 7-14 days and 1-3 months post-operatively. Parents completed surveys before surgery, 1-3 months post-op, and 1+ year post-op. Post-operative cosmesis was assessed by surgeons using the Hypospadias Objective Penile Evaluation (HOPE) score and by parents using the Pediatric Penile Perception Scale (PPPS).
RESULTS
Recruited parents expected a healing time of as little as 4 days. There was a 326.7% increase in parental satisfaction with general cosmesis of the penis from preop to 1-3 months post-op and another 11.6% increase at 1+ year post-op. Mean HOPE score increased from pre-op to 1-3 months post-op by 30.8%, but further increased by only 2.2% at 1+ year post-op. Meanwhile, the Nurse Assessment found 38.0% of children experienced discomfort voiding at 7-14 days post-op.
CONCLUSIONS
While both parents and surgeons may see improvements in cosmesis following hypospadias surgery, surgeons may have earlier perceptions of success compared to parents, who have high expectations regarding surgical outcomes. Care teams should consider ensuring that families understand potential complications after surgery.
09:58 - 10:01
SN06-2 (PP)
Taylor WANG, Shelly KING, Rosalia MISSERI and Konrad SZYMANSKI
Indiana University Health, Riley Pediatric Urology, Indianapolis, USA
PURPOSE
After a circumcision or circumcision revision the patient will typically follow up in clinic four to six weeks after to assess healing and address any parental or patient concerns. A post-operative photo clinic was implemented to help improve access to care by saving families both time and money. Travel distance can be significant as the group provides care to the entire state. The post-operative photo clinic allows families to send in photos one month post-operatively to a secure email address. The photos are then reviewed, and a response is sent to both the family and the primary care clinician. If there are any concerns when the photos are reviewed the patient is called and a visit to the clinic is scheduled.
MATERIAL AND METHODS
Home addresses of a total of 35 patients who attended the post-operative photo clinic during the clinic pilot period were evaluated. Distance to the clinic and cost of travel was calculated using the internal revenue reimbursement estimate. Parking at the clinic costs $2.00.
RESULTS
The average total cost of travel to clinic and parking for the 35 patients evaluated was $118.90. The average daily wage in the state is $254.20 and could have also been potentially lost if the parent or guardian had to take the day off from work to attend an in-person visit.
CONCLUSIONS
In a previous pilot study 100% of the families surveyed felt the clinic saved them time and would recommend the clinic to other families. A post-operative photo clinic can save families both time and money.
10:01 - 10:04
SN06-3 (PP)
Lola BLADT 1, Stine DEMUYS 1, Kaat VANDEPUT 1, Stien VANACKER 1, Alexandra VERMANDEL 2, Gunter DE WIN 2 and Lukas VAN CAMPENHOUT 1
1) University of Antwerp, Product Development, Antwerp, BELGIUM - 2) University Hospital Antwerp, Urology, Edegem, BELGIUM
PURPOSE
The recommended treatment for pediatric urinary incontinence is standard urotherapy, which provides children with age-appropriate information and instructions on drinking and toileting habits. Timer watches can support these routines by reminding children to drink and void at regular intervals. Yet, the repetitive nature of these reminders often leads to children ignoring them. Our goal was to design a more interactive and engaging tool to stimulate awareness of the drinking-voiding loop.
MATERIAL AND METHODS
Interaction Design principles were applied, with a focus on embodiment—designing physical interactions that transform abstract reminders into tangible, interactive experiences. The design process included both low- and high-fidelity prototyping. Feedback from a multidisciplinary panel of experts in Interaction Design and pediatric urology guided iterative refinements.
RESULTS
The final concept, "Peezy," is an interactive wall clock that combines fluid intake monitoring with voiding data to provide personalized reminders. Central to the design is a smart drinking glass mounted on the clock, which embodies the drinking-voiding cycle. The glass rises to prompt drinking times and lowers again when it is returned after drinking, triggering on-screen droplets that gradually fill a liquid mass in the clock’s center, symbolizing the bladder. Using fluid intake and bladder capacity data, the system suggests voiding times, indicated by an animation of a nearly overflowing liquid mass. After voiding, the child pulls a “flusher” cord resembling clock weights, activating animations of liquid flowing out, while voiding data is displayed on-screen in the clock’s center. The clock's outer rim serves as a visual bladder diary, logging drinks and voids as light dots aligned with the hour hand.
CONCLUSIONS
This concept may enhance awareness and engagement in urotherapy by personalizing reminders and physically embodying the drinking-voiding loop with interactive actions. Further research is required to explore its practical application.
10:04 - 10:07
SN06-4 (PP)
Lola BLADT 1, Anka NIEUWHOF-LEPPINK 2, Amélie WISSELS 1, Aube SCHUERMAN 1, Pepijn VISSER 1, Louis DENECKERE 1, Sander LOWETTE 1, Alexandra VERMANDEL 3, Gunter DE WIN 3 and Lukas VAN CAMPENHOUT 1
1) University of Antwerp, Product Development, Antwerp, BELGIUM - 2) UMC Wilhelmina Children's Hospital, Urotherapy, Psychology and Urology, Utrecht, NETHERLANDS - 3) University Hospital Antwerp, Urology, Edegem, BELGIUM
PURPOSE
This study builds on previous research involving focus groups and co-creation sessions with school-aged children undergoing urotherapy. During these sessions, children were asked to draw superheroes with bladder problems. Analysis of their drawings revealed motivations and needs, which informed the design of a urotherapy superhero family. The goal is to enhance child engagement during doctor visits by providing a child-friendly conversation starter.
MATERIAL AND METHODS
A Research through Design methodology was employed, incorporating iterative design and feedback cycles with both children and experts, including pediatric urotherapists, a pediatric urologist, and designers. Three superhero families—ranging from human-like characters to robots and abstract figures—were developed to evaluate preferences across genders and ages. Feedback was collected from 208 children (mean age: 7.0y; SD 2.3y; range: 2–13y; 110 boys, 98 girls) during a Belgian public science event.
RESULTS
Five superheroes were developed, each representing distinct motivations and needs, with magical accessories reflecting their superpowers to avoid superficial preferences based on appearance, such as hair or clothing. The heroes included Action Hero with a training weight (determination), Easy Peasy with pants that keep him dry (low motivation), Protector Hero with a shield (emotional regulation), Mighty Warrior with a sword (resilience building), and Master of Time with a Pee Clock (routine management). Feedback from children showed that the most abstract superhero family was their favorite, preferred by 47% of participants, with similar preferences observed across genders and age groups. Each hero was selected by at least 13% of participants, demonstrating that all were well-received with no single hero being disproportionately favored.
CONCLUSIONS
This study demonstrates how co-creation and creative approaches can contribute to child-centered healthcare. Feedback from children with urinary incontinence is being collected to refine the superhero’s relatability and clinical relevance.
10:07 - 10:10
SN06-5 (PP)
Elisabet HEINA
Queen Silvia's Childrens hospital, Surgery divison, Operation 2 barn, Gothenburg, SWEDEN
PURPOSE
Day surgery units are characterized by a rapid patient flow. In the pediatric setting there is often a delay in discharge due to micturition problem for the child postoperatively.
This might lead to a long day, waiting for the child to pee after minor surgery. Some children have difficulties urinating due to anaesthetic causes, others for surgical reasons. Furthermore, the environment at a hospital can be stressful for children and have a negative impact on the ability to urinate.
The aim for this study was to see if it’s safe for children to be discharged without having peed after day surgery procedures.
MATERIAL AND METHODS
A routine was developed for early discharge, which meant children were discharged prior to micturition if the child’s general condition was good. Excluded procedures were bilateral undescended testis, Fowler Stephens 2 and hypospadias. Thorough oral and written information was given regarding when/where to seek healthcare if the child didn´t urinate the same evening. Written consent was obtained by caregivers.
RESULTS
Out of 1000 children where 122* patients selected for early discharge, 119 of these were eligible for inclusion according to protocol. 2 out of 119 patients had to attend healthcare. 1 patient urinated upon arrival at the ward, 1 needed enema to urinate.
*The 3 excluded patients had hypospadia operation, all 3 needed to attend healthcare to urinate.
CONCLUSIONS
With appropriate information and instructions, discharge prior to urination is safe and can be offered to children after daycare surgery if the caregiver and patient prefer early discharge.
10:10 - 10:13
SN06-6 (PP)
Karin VAN DALEN 1, Mi-Lan WOUDSTRA 2 and Merel VAN VLIET 2
1) Diakonessenhuis Utrecht, Urology, Schoonrewoerd, NETHERLANDS - 2) Universiteit Leiden Instituut Pedagogische Wetenschappen, Faculteit der Sociale Wetenschappen, Leiden, NETHERLANDS
PURPOSE
There is a lack of uniform, evidence-based information on toilet training (TT). Effective TT programs are needed in order to get children toilet trained earlier, hereby preventing bladder and bowel problems, and lowering social, environmental and financial costs. In the present study, a tailored TT program consisting of guidance through an app was tested on effectiveness
MATERIAL AND METHODS
The sample consisted of 171 Dutch 1-4-year-old children who were about to start TT. Children were randomized into either the experimental group, or the control group, in which parents were able to choose their own approach. Within the experimental group, parents could choose to follow an intensive TT program of one week, or a gradual program of ten weeks. Parents filled out questionnaires before the start of the training (T1), two weeks after the start (T2) and three months after the start (T3).
RESULTS
At T2, 30.9% was toilet trained in the experimental group, compared to 16.1% in the control group, χ2=5.135, p=.023. At T3, 68.1% was toilet trained in the experimental group, compared to 51.8% in the control group, χ2=4.219, p=.040. Compared to the control group, only the intensive program was more successful on both T2 (61.1% vs. 16.6% in control group, p<.001) and T3 (75.0% vs. 51.8%, p=.024). The gradual program showed no differences compared to the control group at both time points.
CONCLUSIONS
In conclusion, the intensive one-week program offered in the app was found to be more successful in fostering TT than when parents chose their own methods.
10:13 - 10:16
SN06-7 (PP)
Adam HOWE 1, David SIKULE 1 and Venessa KIRBY 2
1) Albany Medical College, Urology, Albany, USA - 2) The College of Saint Rose, Education, Albany, USA
PURPOSE
Patient experience during urodynamics (UDS) has been associated with high levels of pain, discomfort, anxiety, distress, and embarrassment, which leads to intolerance and noncompliance with UDS. This often leads to the need to undergo anesthesia to place UDS catheters. Animal-assisted therapy (AAT) has been previously shown to help patients to undergo various procedures in the medical setting. The aim of this study is to determine if therapy dogs can help patients with anxiety or inability to cooperate for UDS to avoid requiring sedation or anesthesia to undergo UDS testing.
MATERIAL AND METHODS
Pediatric patients who were previously unable to tolerate UDS due to anxiety, prior trauma, or behavioral issues were included. Patients with allergy to dogs, fear or dogs, conduct disorder, or history of cruelty to animals were excluded. One certified therapy dog used for all patients. Patients spent 30 minutes prior to UDS with the therapy dog, and the dog was present with the patient during UDS. Primary outcomes were if the patient were able to successfully undergo a complete UDS without sedation or anesthesia. Secondary outcomes compared anxiety levels based on visual analog scale before and after dog therapy.
RESULTS
Six pediatric patients previously unable to tolerate UDS underwent AAT, and five were able to successfully complete the UDS testing. Visual analog scales were not significantly different pre and post dog therapy.
CONCLUSIONS
AAT can be a useful option in helping certain patients successfully complete UDS testing without the need for sedation or anesthesia.