ESPU-Nurses Meeting on Wednesday 17, June 2026, 15:10 - 15:50
15:10 - 15:20
SN01-1 (NP)
Jonathan AICHNER 1, Susan MAESTRI 2, Ailsa FERRIE 1, Divyesh DESAI 1 and Ganesh VYTHILINGAM 1
1) Great Ormond Street Hospital, Paediatric Urology, London, UNITED KINGDOM - 2) Great Ormond Street Hospital, Urodynamics, London, UNITED KINGDOM
PURPOSE
Accurate parental education is essential in the care of children with spina bifida, particularly for bladder management and long-term renal preservation. AI-based platforms are increasingly shaping how families obtain information, often beyond clinicians' control. This study examined parental use of online resources and assessed the continued relevance of traditional patient information leaflets.
MATERIAL AND METHODS
A quaternary centre-specific, expert-validated patient information leaflet was mailed to 209 families, who were invited to complete a 25-item online survey evaluating leaflet clarity, usefulness and emotional support, alongside patterns of online and AI-based information use.
RESULTS
Nineteen families participated in the study. The leaflet handed out was rated easy to understand by 89.5% of parents, and 94.7% reported that it improved their understanding of urological care. Emotional concerns were addressed for 94.7% of families, and 94.7% considered the leaflet essential for spina bifida care. Although 84.2% of families used online resources, only 10.5% used AI-based tools such as ChatGPT. Despite online usage, 84.2% found the printed leaflet more helpful and 68.4% felt more reassured by it than by online information. Printed leaflets were considered the most accurate information source by 89.5%, and 94.7% identified the leaflet as essential for families taking care of children with spina bifida.
CONCLUSIONS
Parents of children with spina bifida continue to rely on clear, institution-specific patient information leaflets, which they perceive as more reliable and clinically relevant than generic online or AI-generated sources. These findings support the ongoing development of high-quality, centre-specific leaflets in either printed or digital formats.
15:20 - 15:30
SN01-2 (NP)
Cristian SAGER, Yesica GOMEZ, Carol BUREK, Eliana PONCINI, Javier RUIZ, Nicolas ROSIER, Danel ALBERTI, Otilia BLAIN, Ignacio ARENAS, Francisco IMAZ, Felicitas LOPEZ IMIZCOZ and Santiago WELLER
Garrahan Hospital, Urology, Buenos Aires, ARGENTINA
PURPOSE
Children with neurogenic lower urinary tract dysfunction (NLUTD) due to spinal dysraphism require lifelong bladder and bowel management. Clean intermittent catheterisation (CIC) is the gold standard, yet adherence is influenced by internal and external barriers, caregiver burden and insufficient training. Evidence suggests that multidisciplinary, education-centred programmes improve independence, continence and safety in CIC users. This study evaluates the impact of an integrated urotherapy-CIC programme on urinary and bowel outcomes in paediatric NLUTD.
MATERIAL AND METHODS
Children with spinal dysraphism enrolled in a multidisciplinary bladder-bowel programme (2022-2024) were retrospectively reviewed. Inclusion criteria: NLUTD on CIC. Exclusion: non-neurogenic dysfunction or absence of CIC. The programme included standard urotherapy, pelvic/postural physiotherapy, nurse-led CIC/auto-CIC training or retraining, voiding diaries, Bristol stool scale and Rome IV criteria. Constipation was defined as Bristol 1-2 and <3 stools/week from age ≥4; faecal incontinence as >3 weekly episodes from age ≥6. Data were collected using REDCap. Descriptive statistics and chi-squared testing were performed (Stata 18).
RESULTS
A total of 189 children were included (84% myelomeningocele; mean age 7.6 years; 50% female). CIC was performed via urethra in 95% and via stoma in 5%. Catheter reuse occurred in 45%. CIC frequency averaged 3-4/day (44%), with nocturnal indwelling catheters in 21% under age 3. Constipation affected 27%, and faecal incontinence 50%.
At enrolment: first-time CIC training (21%), retraining (39%) and auto-CIC (40%). Retraining was required due to incorrect technique (62%), resistance (16%), limited time (7%) or lack of resources (9.6%).
After integrated urotherapy, CIC frequency increased (34→42%), constipation decreased (22%) and faecal incontinence reduced (33%). Auto-CIC rose to 45%. CIC complications declined: UTI (26→15%) and urethrorrhagia (5.4→4.7%), with no false passages or catheter knotting. Girls had more constipation (p=0.040) yet longer dry intervals (p=0.026). CIC ≥4/day was associated with continence (p=0.05). Retraining was strongly associated with CIC <4/day (p=0.000). Lubricated catheters were associated with higher continence rates (p=0.005).
CONCLUSIONS
A structured, multidisciplinary urotherapy-CIC programme improved catheterisation frequency, autonomy, bowel status and CIC-related complications. These findings reinforce the value of interdisciplinary training models in paediatric NLUTD.
15:30 - 15:40
SN01-3 (NP)
Sahrish MASOOD, Usman KAHLOON, Abby VARGHESE, Joana DOS SANTOS and Michael CHUA
The Hospital For Sick Children, Division of Urology, Toronto, CANADA
PURPOSE
Myelomeningocele (MMC) is associated with early neurogenic bladder and bowel dysfunction and long-term risks to renal health. Although postnatal closure remains standard, prenatal repair has been introduced with the goal of improving neurological and functional outcomes. Its early urologic impact, however, remains unclear.
MATERIAL AND METHODS
This retrospective single-centre chart review, with institutional approval (REB #1000077457), included all children with MMC who underwent surgical repair up to the end of 2024. Variables included demographics, repair type and urological outcomes. Comparisons between groups were performed using Fisher’s Exact test.
RESULTS
Baseline sex distributions was similar between groups. Clean intermittent catheterization was more common after prenatal repair (100% vs 75%, p=0.02). Bowel and bladder incontinence therapies were used at comparable rates. Early bladder trabeculation did not different, although later imaging showed a trend toward higher trabeculation in the prenatal group (38% vs 13%, p=0.06). Medication use was similar except for beta-blockers (83% vs 47%, p=0.01). Renal imaging findings showed no difference in hydronephrosis; however, prenatal repair was associated with higher early vesicoureteral reflux confirmed by imaging (43% vs 9%, p=0.01), while later reflux rates were similar. UTI rates were comparable, as well as mobility support needs.
|
Baseline Variable |
Prenatal (n=18) |
Postnatal (n=60) |
p-value |
|
Sex, N (%) |
0.19 |
||
|
Male |
6 (33) |
31 (52) |
|
|
Clean Intermittent Catheterization, N (%) |
0.02 |
||
|
Yes |
18 (100) |
45 (75) |
|
|
Self-catheterization, N (%) |
0.08 |
||
|
Yes |
2 (11) |
21 (35) |
|
|
Bowel Treatment, N (%) |
0.77 |
||
|
Yes |
14 (78) |
43 (72) |
|
|
Botox Injection, N (%) |
0.41 |
||
|
Yes |
8 (44) |
20 (33) |
|
|
Bladder Trabeculation (Early), N (%) |
0.31 |
||
|
Yes |
5 (31) |
10 (19) |
|
|
Bladder Trabeculation (Latest), N (%) |
0.06 |
||
|
Yes |
6 (38) |
5 (13) |
|
|
Mitrofanoff present, N (%) |
0.44 |
||
|
Yes |
1 (6) |
10 (17) |
|
|
Urinary Tract Infection, N (%) |
0.42 |
||
|
Yes |
10 (56) |
26 (43) |
|
|
Anticholinergic, N (%) |
0.59 |
||
|
Yes |
8 (44) |
33 (55) |
|
|
Alpha-blocker, N (%) |
0.33 |
||
|
Yes |
1 (6) |
8 (13) |
|
|
Beta-blocker, N (%) |
0.01 |
||
|
Yes |
15 (83) |
28 (47) |
|
|
Hydronephrosis (Earliest), N (%) |
0.13 |
||
|
Yes |
3 (19) |
3 (6) |
|
|
Hydronephrosis (Latest), N (%) |
0.19 |
||
|
Yes |
2 (12) |
1 (3) |
|
|
VCUG Reflux (Earliest), N (%) |
0.01 |
||
|
Yes |
6 (43) |
4 (9) |
|
|
VCUG Reflux (Latest), N (%) |
0.58 |
||
|
Yes |
2 (25) |
2 (12) |
|
|
Mobility Support, N (%) |
0.40 |
||
|
Yes |
10 (56) |
41 (68) |
CONCLUSIONS
Prenatal MMC repair did not demonstrate an early urologic advantage in this cohort and appears to follow a clinical trajectory similar to postnatal repair. Given the higher proportion of prenatal repair patients who require beta-agonists, it seems appropriate that our institution initiates CIC for all prenatal repair patients.
15:40 - 15:50
SN01-4 (NP)
Tugce Merve ORBAY ERECAN, Merve DEDE, Aysegul AKBULUT, Mehmet Ugur YILMAZ and Nizamettin KILIC
Uludag University Faculty of Medicine, Pediatric Urology, Bursa, TÜRKIYE
PURPOSE
Mitrofanoff channel strictures are clinically significant postoperative complications following the Mitrofanoff procedure and frequently results in difficulty with catheterization and repeated interventions. Although several surgical strategies exist for managing mitrofanoff strictures, recurrent strictures remains challenging and may necessitate innovative reconstructive approaches. This study reports the successful use of an oral mucosal graft in the managing of an approximately 2 cm long mitrofanoff channel stricture located just below the VQZ stoma.
MATERIAL AND METHODS
A 12-year-old girl with spina bifida, hypocompliant low bladder capacity, and bilateral vesicoureteral reflux had previously undergone ileocystoplasty with creation of a Mitrofanoff channel and sling procedure. At postoperative month six, she presented with inability to perform clean intermittent catheterization. Cystoscopy demonstrated an approximately 2-cm stenotic segment just below the VQZ stoma. Serial percutaneous dilations were performed; however, the stenosis recurred, necessitating two additional dilation sessions. Repeat cystoscopy confirmed a persistent 2-cm stenosis and we decided an open surgical repair.
A midline incision of approximately 4 cm was made, preserving and keeping the VQZ orifice intact. The narrowing segment of the Mitrofanoff channel was circumferentially mobilized, and partially rotated and a 2 cm vertical incision was made on the dorsal surface of the stricture and the lumen exposed. A 2 × 1.5 cm oral mucosal graft harvested from the lower lip was sutured to the margin of the mitrofanoff mucosal opening and narrowed segment was augmented. The lumen was calibrated over a 12 fr catheter. All steps were recorded with photographs.
RESULTS
The catheter was removed at 21th day postoperatively. The patient subsequently resumed clean intermittent catheterization without difficulty. No restenosis, leakage, or procedure-related complications were observed during follow-up.
CONCLUSIONS
Oral mucosal grafting represents a feasible and effective alternative for the managing continent catheterizable channel stricture following the Mitrofanoff procedure. Its favorable tissue compatibility and robust epithelialization render it suitable for reconstructing stenotic segments. Surgical expertise and individualized approach to the patient and case remain key determinants of optimal outcomes in these complex revisions.