ICCS & ESPU-Nurses Meeting on Friday 5, September 2025, 10:25 - 10:43
10:25 - 10:31
ICCS-S03-1 (OP)
Sharon MOHAN KUNNATH, Sara LOBO, Anu PAUL, Massimo GARRIBOLI, Arash TAGHIZADEH and Pankaj MISHRA
Evelina London Children's Hospital, Paediatric Urology, London, UNITED KINGDOM
PURPOSE
Supply issues with commercially available SPL that we use for urodynamics prompted us to seek alternatives. We evaluated an alternative device.
Suprapubic lines (SPL) for urodynamics have been used routinely in our unit. The aim was to evaluate the use of an improvised suprapubic line for video urodynamics (VUD) at a tertiary Paediatric urology unit.
MATERIAL AND METHODS
Retrospective case review.
Under general anaesthesia, 14 G Abbocath® cannula (Hospira Inc,USA) was used to introduce 4 Fr feeding tube (Vygon®,UK) which was then secured with Silk. Urodynamics was performed the same day.
Outcome measures were surgical time and complications. Data quoted as median (IQR).
RESULTS
25 patients had this improvised SPL. Patient age at procedure was 111 months (42-152 months). The surgical time was 18 minutes (15-20 minutes). Extravasation occurred during VUD in one patient. Two patients with known voiding problems were unable to void for the VUD study and were admitted for observation overnight with one needing urethral catheter insertion This complication rate of 3/25 compares is similar to historical series.
Of note the described technique represents a considerable cost saving of 42.16 pounds/49.84 Euros over the previously used commercial alternative.
CONCLUSIONS
The described technique has an acceptable clinical outcome and is economically favourable. It is a safe method that is cost saving but needs further evaluation.
References:
[1] Bhandarkar K, Giannettoni A, Mishra P, Paul A, Clothier J, Manuele R, et al. Morbidity following suprapubic line insertion for videourodynamics in children. Journal of Pediatric Urology 2023;19:247.e1-247.e6. https://doi.org/10.1016/j.jpurol.2023.01.007.
10:31 - 10:37
ICCS-S03-2 (OP)
Michelle HSIA, Jason VAN BATAVIA and Joy KERR
Children's Hospital of Philadelphia, Urology, Philadelphia, USA
PURPOSE
Patients with Spina Bifida (SB) experience Neurogenic Bowel Dysfunction (NBD) and require a daily enema program to become socially continent of feces. The cone ostomy irrigator is typically the first enema device introduced at typical time of potty training, administered by the caregiver daily. The transition to independence with bowel management using this device is difficult for SB patients who may have problems with manual dexterity and balance while sitting on the toilet. Our goal was to develop an assistive device that could allow patients with SB to become independent in administering the cone enema, which allows patients to become autonomous, therefore improving quality of life.
MATERIAL AND METHODS
Our team consists of an Occupational Therapist, Nurse Practitioner and a Urologist. We submitted our idea for an assistive device to the Sprint program through an internal funding mechanism for medical device innovation and were awarded a grant to bring our device to fruition. We partnered with an outside engineering firm to bring the concept to prototype. With the first prototype, we performed am IRB approved pilot study including 10 patients with NBD who came to our office for an evaluation of manual dexterity, upper body range of motion, core strength and executive function. We taught patients and their families how to use the assistive device with their existing cone enema system and sent them home for a one week trial of the device with planned video visit for feedback.
RESULTS
While use of the device was feasible, patient and family feedback highlighted areas of improvement which we are incorporating into the next iteration of the device.
CONCLUSIONS
Patients and families reported that use of the assist device increase independence in bowel management was life changing.
10:37 - 10:43
ICCS-S03-3 (OP)
Lillian HAYES, Mélise KEAYS, Regina THAM, Rachel SAUNDERS and Stuart BAUER
Boston Children's Hospital, Urology, Boston, USA
PURPOSE
Clean Intermittent Catheterization (CIC) is a mainstay for managing bladder dysfunction in individuals with lower urinary tract dysfunction. Little information exists regarding how it affects intimacy & sexuality. We aimed to enhance our understanding of how patients and caregivers perceived and navigated these sensitive issues.
MATERIAL AND METHODS
Semi-structured interviews were conducted, evaluating various aspects of how CIC has impacted the lives of patients and their caregivers. Purposeful sampling methods identified eligible families. Between 8/2018-10/2019, 52 interviews were conducted with patients and caregivers. Questions about intimacy and sexuality were asked of all caregivers and of patients >18 years. Interview transcripts were de-identified, coded, and analyzed.
RESULTS
Patients >18 years old (n = 19) expressed (1) fear of rejection on disclosure of CIC [37%]; (2) increased confidence with advancing maturity [37%] (3); CIC affected spontaneity & increased anxiety around intimacy [11%]; (4) frustration with inadequate sexual health information [21%]. Caregivers (n = 26) expressed (1) concerns about how CIC would affect intimacy & sexuality [23%]; (2) lack of direction regarding how to approach discussions with their children [50%].
CONCLUSIONS
CIC presents unique challenges in intimate partner relationships. While these challenges could be alleviated with appropriate guidance and dialogue from caregivers and healthcare providers, patients and caregivers voiced receiving inadequate counseling from them in these areas. Appropriate sexual health information and guidance around approaching these conversations early would empower patients and families to have more open discussions about sexual health and improve how patients adapt to this important aspect of their lives.