ICCS & ESPU-Nurses Meeting on Thursday 4, September 2025, 14:20 - 15:34
14:26 - 14:32
SN07-1 (OP)
Ji JEONGEUN 1, Park JIEUN 2, Ji YOONHYE 2, Han SANG WON 3, Kim SANG WOON 4 and Lee YONG SEUNG 4
1) Severance Children's Hospital, Department of Pediatric Urology, Seoul, REPUBLIC OF KOREA - 2) Department of Pediatric Urology, Severance Children's Hospital, Seoul, REPUBLIC OF KOREA - 3) CHA Gangnam Medical Center, CHA University, Department of Urology, Seoul, REPUBLIC OF KOREA - 4) Yonsei University College of Medicine, Department of Urology and Urological Science Institute, Seoul, REPUBLIC OF KOREA
PURPOSE
To evaluate the clinical utility of urodynamic study (UDS) and video urodynamic study (VUDS) in pediatric patients with lower urinary tract symptoms (LUTS) and to determine cases where VUDS is essential and can be replaced only by UDS test.
MATERIAL AND METHODS
From 2014 to 2023, a retrospective analysis was conducted on 3,885 pediatric LUTS patients aged 5 to 18 years. Patients with confirmed anatomical abnormalities were excluded. VUDS was performed in 141 patients (3.6%), and UDS was performed in 19 patients (0.4%). Patients were classified into:
Group 1: Tests determined at the initial examination based on symptoms.
Group 2: Tests performed after abnormalities were found in basic urination tests.
Group 3: Tests conducted after standard voiding treatments (e.g., constipation management, urination training) and medications failed to improve symptoms.
RESULTS
UDS effectively evaluated functional abnormalities, with drug treatment in 4 cases, hydrodistension in 2 cases, and Botox treatment in 4 cases.
VUDSidentified additional abnormalities in 36 patients (25.5%), including VUR and urethral lesions.
Group 1: Among 16 patients with LUTS and urinary tract infections, 7 patients (43.7%) were diagnosed with VUR, 6 of whom were female.
Male patients with mild or no abnormalities in urination tests were diagnosed with urethral lesions via VUDS, and all showed symptom improvement after surgery.
CONCLUSIONS
VUDS is essential for diagnosing complex anatomical abnormalities, particularly in female patients with urinary tract infections and male patients with suspected urethral lesions. On the other hand, UDS is a safe and effective alternative for evaluating functional urination abnormalities or cases without anatomical concerns due to its lack of radiation exposure. The selective use of VUDS and UDS optimizes diagnostic accuracy and treatment outcomes. Further studies are recommended to evaluate the additional diagnostic value of VUDS.
14:32 - 14:38
SN07-2 (OP)
Filine VAN DEN BOSCH 1, Paul VAN LEUTEREN 1, Sandra TOBISCH 2 and Diederick DUIJVESZ 3
1) Novioscan B.V. - an Essity company, IQ Solutions, Nijmegen, NETHERLANDS - 2) BSN medical GmbH - an Essity company, Clinical Affairs, Hamburg, GERMANY - 3) Canisius Wilhelmina Hospital, Department of Urology, Nijmegen, NETHERLANDS
PURPOSE
The TENA SmartCare Bladder Sensor, a wearable device, supports children (≥ 6 years) and adults (BMI ≤ 25 kg/m²) by tracking bladder filling and notifying users when to go to the bathroom via vibration or in-app notifications. The primary objective of this study was to demonstrate the sensor's ability to detect the bladder before urination among adults. Secondary objectives included evaluating performance, safety, usability, user satisfaction, and impact on quality of life (QoL). The hypothesis was that the median bladder detection rate would exceed 85% (H0: ≤0.85, H1: >0.85, p-value <0.05).
MATERIAL AND METHODS
Adults (≥ 18 years) with urinary incontinence tested the sensor at home for one week. Performance, safety, usability, satisfaction, and QoL were assessed. Subjects documented urination and urine loss in a diary. Raw data was analysed to evaluate bladder detection and notification rates.
RESULTS
30 adults (67% female, 33% male; median age 53 years; median BMI 22.6 kg/m²) completed the study. The median bladder detection rate was 89.8% (IQR 82.6%-95.3%) in a sample without statistically and clinically identified outliers (n = 28), and the null hypothesis was rejected (z = 69, p<0.05). The median actual full bladder notification rate was 63.1% (IQR 50.0%-71.4%), and the median perceived rate was 94.4% (IQR 87.0%-105.6%). The device reduced unwanted leakages by 67% and improved QoL.
CONCLUSIONS
The Bladder Sensor effectively detects the bladder in real-life conditions and supports urinary incontinence prevention. Its effectiveness seemed to depend on anatomical factors, bladder volume, and/or proper fixation. The device had a positive effect on the subject's urinary incontinence, their QoL and overall well-being while testing it for one week. Long-term benefits of the Bladder Sensor as an adjunct tool in continence care management needs to be investigated.
14:38 - 14:44
SN07-3 (OP)
Winifred NUGENT, Arash TAGHIZADEH, Claire TAYLOR and Jonathon OLSBURGH
Guys and St Thomas NHS Trust, Urology, London, UNITED KINGDOM
PURPOSE
Introduction
Young Onset Urology (YOU) describes benign, complex urological conditions, including congenital diagnoses, affecting patients transitioning from paediatric to adult services. A Clinical Nurse Specialist (CNS) role bridges this transition, offering CNS-led and joint consultant clinics and individualised holistic support.
MATERIAL AND METHODS
Methods
A three-month prospective, user friendly questionnaire was used to evaluate patient experience of the YOU service including user satisfaction, knowledge base and gaps, and identify areas for improvement
RESULTS
Results
The questionnaire was offered to 61 patients with a response rate of 84% (51 patients: 29 (57%) male and 22 (43%) female).
Experience of care: 50 patients (98%) stated they were always treated with dignity and respect and 48 (94%) rated their care as excellent/very good.
Knowledge and understanding: responders rated their understanding of their condition on a 5-point Likert scale:
1: (poor): 5 patients (10%)
2: 3 patients (6%)
3: 13 patients (25.5%)
4: 17 patients (33%)
5: (excellent): 13 (25.5%)
6 patients (12%) did not know the name of their condition. 4 of these patients scored their knowledge as 1 (with a further 2 scoring 3 and 4 respectively)
Areas for improvement: 6 responders (12%) had little confidence speaking alone during consultations. 11 patients (22%) wanted to learn more about navigating college/university with their condition. 14 patients (27%) wanted help managing work.
CONCLUSIONS
Conclusion
Supported transition to adult services was rated highly with variability in the understanding of individual conditions. Ongoing support will include improvement in patient knowledge, support in education and work, and development of independence and confidence.
14:44 - 14:50
SN07-4 (OP)
Ulrika SVENNINGHED 1, Elin ÖST 2, Gundela HOLMDHAL 2, Lisa ÖRTQVIST 2, Magdalena BOIJE 2, Sofia SJÖSTRÖM 1, Cecilia LINDSTRÖM GRUBER 2 and Michaela DELLENMARK BLOM 1
1) THE QUEEN SILVIA CHILDREN'S HOSPITAL, SAHLGRENSKA UNIVERSITY HOSPITAL, DEPARTMENT OF PEDIATRIC SURGERY, Gothenburg, SWEDEN - 2) ASTRID LINDGRENS CHILDREN'S HOSPITAL, KAROLINSKA UNIVERSITY HOSPITAL, DEPARTMENT OF PEDIATRIC SURGERY, Stockholm, SWEDEN
PURPOSE
Items of a condition-specific health-related quality of life (HRQoL) questionnaire should be generated from affected children’s/parents’ experiences to ensure important content for them is measured. Such a questionnaire has not existed for children with bladder exstrophy-epispadias-complex (BEEC). We hypothesized that children with BEEC experience specific impact due to their condition. The study aim was to describe those experiences to develop of a condition-specific questionnaire.
MATERIAL AND METHODS
Prospectively, ten focus groups with 37 participants (14 children aged 8-18 matched for different severity of BEEC; 23 parents of children with BEEC aged 0-18) were held at two tertiary pediatric urology departments in Sweden, led by a moderator, audio-recorded and transcribed. Reports of children’s BEEC-related HRQoL were extracted from transcripts, content analyzed, categorized into HRQoL domains to aid item generation. According to well-established principles of qualitative research, no controls or hypothesis testing were used.
RESULTS
1730 experiences were identified and allocated into seven HRQoL domains, several sub-domains each, aiding item generation for a condition-specific HRQoL questionnaire:
CONCLUSIONS
This is the first reported focus group study in BEEC children and reveals their possible physical, psychological and social impact in life. This information enables the development of a condition-specific HRQoL questionnaire for children with BEEC. This is needed to improve patient-centered care and research.
14:50 - 14:56
SN07-5 (OP)
Anna CRASTAN 1, Christina SCHULER 2, Norma RUPPEN 3, Maya HORST 4 and Uchenna KENNEDY 4
1) Universitäts-Kinderspital Zürich, Chirurgische Abteilung, Zürich, SWITZERLAND - 2) ZÜRCHER HOCHSCHULE FÜR ANGEWANDTE WISSENSCHAFTEN DEP. GESUNDHEIT, Gesundheit, Winterthur, SWITZERLAND - 3) Universitäts-Kinderspital Zürich, Psychologie, Zürich, SWITZERLAND - 4) Universitäts-Kinderspital Zürich, Chirurgie / Urologie, Zürich, SWITZERLAND
PURPOSE
Variations of Sex Characteristics (VSC) are rare conditions that require an interprofessional approach. To address the known challenges faced by VSC-individuals and their parents, we established a standardized interprofessional setting for consultation and long-term accompaniment. A detailed understanding of the needs of affected children and their parents is lacking.
This study aimed to explore the experiences and needs of children with VSC and their parents regarding the interprofessional care setting and their perception of the "three-pillar concept": Family Support - Milestone concept - Flowchart for decision making.
MATERIAL AND METHODS
We used a qualitative, descriptive study design to conduct exploratory, semi-structured interviews from August- November 2024. The audio-recorded interviews were transcribed verbatim and analyzed in three coding cycles according to Saldaña's methodology.
RESULTS
The 15 interviews with five affected children and 12 parents highlighted the need for understandable information and revealed participants concerns about future fertility and sexuality. Peer exchange and trusting relationships with professionals were mentioned as central elements. The interprofessional setting and the three-pillar concept were rated positively by children and parents; but lack of knowledge of medical professionals outside the field was noted.
CONCLUSIONS
This is the first study to identify the needs of children with VSC alongside those of parents. Children with VSC and their parents need an empathic and long-term interprofessional care. The planned three-pillar concept provides better standardization, can reduce uncertainty, stress, and aids in preparing for consultations. Peer exchange should be enabled and implemented in the clinical setting in a more standardized manner.
14:56 - 15:02
SN07-6 (OP)
Suzanne OOSTLAND 1, Floor ROZEMEIJER 1, Fred VAN DER TOORN 2 and Rogier SCHROEDER 3
1) Wilhelmina Kinderziekenhuis Utrecht, Pediatric Urology, Utrecht, NETHERLANDS - 2) Erasmus MC, Pediatric Urology, Rotterdam, NETHERLANDS - 3) UMC Utrecht, Pediatric Urology, Utrecht, NETHERLANDS
PURPOSE
In pediatric distal hypospadias repair, varying catheter diameters are employed for neourethral reconstruction. The longterm impact of the intra-operative catheter diameter on postoperative outcomes are not well studied. This study aims to investigate the correlation between intraoperative catheter diameter and the incidence of complications and reoperations at the age of five.
MATERIAL AND METHODS
This study is part of the prospective multi-centered observational cohort study, the Dutch Hypospadias Study. 728 pediatric patients were included. Inclusion criteria were restricted to patients requiring neo-urethral construction during the hypospadias surgery. Subjects were stratified by urethral catheter diameter used in urethroplasty into two cohorts: smaller-caliber catheters (Ch 6, Ch 8) and larger-caliber catheters (Ch 10, Ch 12). Outcome measures were assessed at six months and five years postoperatively (mean follow up 3.8 years). The primary outcome measures included the incidence of postoperative complications; wound dehiscence, meatal stenosis and fistula formation. The need for surgical revision was evaluated as the secondary outcome.
RESULTS
No significant differences were observed in the incidence of intracutaneous fistula formation or meatal stenosis between the two groups. Significantly more patients had a wound dehiscence in the larger-caliber cohort (15.2% vs. 7.0% in the smaller-caliber cohort). Also the larger-caliber cohort showed significantly more reoperations (21.0% vs. 8.7% in the smaller-caliber cohort).
CONCLUSIONS
The intraoperative catheter size in hypospadias surgery significantly affects the postoperative outcomes wound dehiscence and leads to a higher reoperation rate. Careful preoperative planning and consideration of catheter size appears of the essence. However, additional studies are required to evaluate its correlation with long-term functional outcomes.
15:02 - 15:08
SN07-7 (OP)
Floor ROZEMEIJER 1, Fred VAN DER TOORN 2, Suzanne OOSTLAND 1 and Rogier SCHROEDER 3
1) Wilhelmina Kinderziekenhuis (WKZ), Pediatric urology, Utrecht, NETHERLANDS - 2) Erasmus MC, Ped, Rotterdam, NETHERLANDS - 3) UMC Utrecht, Pediatric urology, Utrecht, NETHERLANDS
PURPOSE
Following urethroplasty for hypospadias a reduced Qmax can be observed. Whether this translates into functional symptoms is, however, unknown. During urethroplasty various catheter sizes can be used to form the neo-urethra. We hypothesize that larger catheters might result in better functional outcomes during follow-up. In this study we analyzed the effect of catheter sized used during urethroplasty on functional outcomes.
MATERIAL AND METHODS
All patients were included in the Dutch Hypospadias Study (DHS) a prospective multi-centered observational cohort study. All included patients underwent urethroplasty for midshaft and distal hypospadias. Patients with post-operative complications were excluded. The following outcomes were evaluated at five- and ten-years of age: Qmax using flowmetry, bladder diary assessing voiding frequency, maximum voided volume and incontinence along with patient reported evaluation of micturition stream and their through questionnaire assessed toilet training status (initiation of day and night continence). Patients were divided in two groups based on catheter diameter used intraoperatively: large catheter group (Ch 10 & Ch 12) vs small catheter group (Ch 6 & Ch 8).
RESULTS
304 patients were evaluated at age five and 142 at age ten. Qmax was statistically significantly higher for patients in the large-caliber catheter group compared to the small-caliber catheter group at both five and ten years. At age five, 28.1% of the smaller catheter group had a Qmax below 10ml/s compared to 13.9% of the larger catheter group (p=0.007). No differences in other functional outcomes were observed between both groups at age five and ten.
CONCLUSIONS
There are statistically significant differences in Qmax between the two catheter size groups at the age of five and ten years in favor of larger size catheters. These differences do not translate into variations in functional outcomes between the groups.
15:08 - 15:14
SN07-8 (OP)
Michail AFTZOGLOU 1, Catrin GRIFFITH 2, Eskinder SOLOMON 3, Massimo GARRIBOLI 1 and Pankaj MISHRA 1
1) Evelina London Children's Hospital, Department of Paediatric Urology, London, UNITED KINGDOM - 2) Evelina London Children's Hospital, Paediatric Urology Department, London, UNITED KINGDOM - 3) Guy's and St. Thomas Hospital, Department of Urology, London, UNITED KINGDOM
PURPOSE
To evaluate changes in bladder capacity and voiding efficiency during the first 12 months of life in boys with PUV after valve resection
MATERIAL AND METHODS
Infants with PUV underwent 4-hours observational study, measuring voided volumes and post-void residuals (PVR) twice during the first year of life after PUV ablation. The first assessment was performed immediately after valve resection (BFA1) and the second approximately 6 months later (BFA2). The mean difference in the measured bladder capacity (MBC)/ expected bladder capacity (EBC) ratio and PVR were calculated and statistically significant difference assessed using a one sample t-test. The bladder was categorized ‘Small’(<65%EBC) and ‘large’(>150%EBC) as defined by the ICCS (Austin et al. J Urol 2014;191(6)(1863):e5-13)
RESULTS
33 male infants from 2015 to 2024 had bladder function assessed at a median age of 1 month(BFA1, range 0-8) and 6 months(BFA2:2-12). The mean difference between the MBC/EBC ratioand PVR at first and second assessment was 0.11(+\- 0.95) and 1.4ml(+/-18.6mls), respectively. This mean difference was not statistically significant (MBC/EBC:0.937,p-value:0.356 and PVR: -0.22(p-value:0.832). Normal bladder capacity was found in 72.7% at the 1st assessment (BFA1:24/33) compared to 69.7% at the second(BFA2:23/33). At BFA1 6.1%(2/33) and at BFA2 12,1%(4/33) had small capacity bladder, whereas a‘large bladder’was found in 21.2%(BFA1:7/33) and 18.2%(BFA2:6/33).
CONCLUSIONS
MBC/EBC ratio and PVR appears to remain unchanged during the initial months after PUV resection. The proportion of boys with “small”, “normal” and “large” capacity also remains unchanged during this period.
15:14 - 15:20
SN07-9 (OP)
Alba Maria HERNÁNDEZ PÉREZ, Natalia GALLEGO MELLADO, Oscar SANCHEZ PARIS and Jeronimo GONZALVEZ PIÑERA
Hospital General Universitario Dr. Balmis, Cirugía Pediátrica, Alicante, SPAIN
PURPOSE
Pediatric kidney stones often require multiple interventions. There are many options, including less invasive procedures, with different benefits. This study aims to compare the efficacy and complications between mini-PERC and RIRS.
MATERIAL AND METHODS
This retrospective observational study included patients 0-14 years old who underwent mini-PERC and RIRS at our institution between 2009-2024. Patient demographics, medical conditions, stone characteristics (location, size, composition), stone-free rate, surgical time, hospital stay and early complications (using Clavien-Dindo scale, CD) were analyzed.
RESULTS
A total of 20 participants were included: 9 RIRS, 11 mini-PERC. The mean age was 8 years(1-14) with 57.9% males. Lithogenic factors were present in 42% (3 cystinuria, 2 hypercalciuria). There were no significant differences in age (p=0.82), sex (p=0.68), location (p=0.18), size (p=0.087), medical conditions (p=0.47), composition (p=0.92), operative time (mini-PERC: 150(80-240) vs RIRS: 120(60-395) min, p=0.5), hospital stay (1 (1-12) vs 1(1-3) days, p=0.64) or double J placement (p=0.9). The stone-free rate was significantly higher (p=0.042) for mini-PERC (81%) compared to RIRS (44%). RIRS had a higher complication rate (66%) than mini-PERC (18%) (p=0.02, RR=1,14). RIRS complications included 3 cases of stone migration, whereas mini-PERC included 1 (CDIIIb).
CONCLUSIONS
Mini-PERC technique is an effective and safe treatment option for renal stones in pediatric population, offering a higher stone-free rate and fewer complications compared to RIRS.
15:20 - 15:26
SN07-10 (OP)
Katie READ 1, Karen RYAN 2, Alexander CHO 3 and Naima SMEULDERS 3
1) Great Ormond Street Hospital, London, UNITED KINGDOM - 2) Great Ormond Street Hospital, Urodynamics, London, UNITED KINGDOM - 3) Great Ormond Street Hospital, Urology, London, UNITED KINGDOM
PURPOSE
A clinical nurse specialist led renal stones clinic was implemented in October 2020 as a direct response to an increasing number of renal stones patients being seen at GOSH and the subsequent impact on clinical availability, cost and patient care.
The aim of the new clinic was to improve patient care and reduce demand on other clinic services.
MATERIAL AND METHODS
After a period of observing the Urolithasis MDT clinic, a new CNS-led clinic was started. There were 4-5 slots of 30 minutes duration. The CNS-clinic integrated: same-day US-scan, lifestyle dietary advice, fluid-intake recommendations and urinary metabolic-screens.
Patients requiring MDT-clinical input were presented in the monthly virtual meeting. The clinical team were available for urgent same-day advice if needed.
12-CNS clinics over six months were reviewed and compared with a 3-month audit of the Urolithiasis MDT-clinic. Data was collected retrospectively. Statistical test:Chi-squared.
RESULTS
Since the onset of the clinic 688 patients have been seen over 4 years
In the 12 CNS-clinics reviewed, 26/30, (80%) had completed full urinary metabolic screens (2 of those who hadn’t patients had global development delay and 1 patient was non-compliant over several appointments with providing urine samples) which is statistically higher than 44% from the MDT-Clinic (<0.00002).
CONCLUSIONS
A CNS-led Urolithiasis clinic can be succesfully implented and is a beneficial expansion of the Stones-service. More clinic spaces are made available and patients receive a dedicated thorough work-up and consult.
15:26 - 15:32
SN07-11 (OP)
Abdurrahman ONEN
Dicle University Medical Faculty, Pediatric Urology, Sur, TÜRKIYE
PURPOSE
We aimed to determine pre and postoperative behaviour and risk of severe UVJO, clarify surgical indications and long-term results in such infants.
MATERIAL AND METHODS
66 infants who underwent surgery due to severe UVJO in 2012-2023 were prospectively evaluated. Diameter of distal ureter, thickness of parenchyma, degree of hydronephrosis and renal function were evaluated. Surgical indications were symptom, ureter(>15mm), parenchyma(≤3mm), echogenecity, function(<40%). Postoperative complications, reoperation and long-term results were evaluated.
RESULTS
There were 66 infants who had long-term follow-up. 57(86,4%) infants were boys. 42(63,6%) had left UVJO. 27 infants developed UTI before surgery. The mean diagnosis age was 3,3 months. The mean diameter of ureter was 19mm, while mean parenchymal thicness 3,2mm. The mean preoperative renal function was 37,8%. The mean age at operation was 4,1months. Surgical indication was symptom in 30 infants, diameter of ureter(>15mm) in 48, thickness of parenchyma(≤3mm) in 39, echogenecity in 27, decreased function(<40%) in 33, and severe problem in contralateral kidney in 18 infants. Primary operation was JJ-stent placement in 63 infants while ureteral reimplantation in three. The median postoperative followup period was 7(1-12)years. Postoperative complication was reccurent UVJO after endoscopic treatment in 36infants, UTI in 30 and JJ-stent migration in 6. Reoperation required in 39(59%)infants. 42(63,6%) infants recovered well, while 24 persisted low renal function(<40%) with significant decrease in hydronephrosis.
CONCLUSIONS
The rate of preoperative symptom (mostly UTI) and renal deterioration, and postoperative complication and reoperation are significantly high in such infants. Therefore, close pre and postoperative followup are crucial in preserving these kidneys. Presence of symptom, diameter of ureter(>15mm), parenchyma(≤3mm), echogenecity and function(<40%) should be surgical indications in infants with severe UVJO. After endoscopic catheter removal close followup particularly for presence of UTI and increase in hydronephrosis is important.