ESPU-Nurses Meeting on Wednesday 17, June 2026, 16:40 - 17:40
16:40 - 16:50
SN03-1 (NP)
Hüseyin BILGI 1, Merve DEDE 2, Ayşegül AKBULUT 2, Tuğçe Merve ORBAY 2, Mehmet Ugur YILMAZ 2, Nizamettin KILIÇ 2 and Mehmet Emi̇n BALKAN 2
1) Bursa Uludag University Faculty of Medicine, Pediatric Surgery, Nilufer, TÜRKIYE - 2) Bursa Uludag University Faculty of Medicine, Pediatric Urology, Nilufer, TÜRKIYE
PURPOSE
Patients with differences of sex development (DSD) who present with a common urogenital sinus require individualized surgical reconstruction. While the anatomical and cosmetic outcomes of various techniques are well described, their long-term impact on urinary function remains insufficiently defined. This study aimed to evaluate urinary continence and voiding outcomes in a large DSD cohort and to determine whether the choice of surgical technique is associated with differences in lower urinary tract symptoms (LUTS).
MATERIAL AND METHODS
A retrospective review was conducted of 51 patients older than 5 years who underwent urogenital sinus surgery between 1990 and 2020. The mean age at follow-up was 18.8 ± 7.3 years. Diagnoses included congenital adrenal hyperplasia (66.7%), vaginal atresia (n=5), Müllerian agenesis (n=4), mixed gonadal dysgenesis/Turner variants (n=3), testicular feminization (n=1), imperforate hymen (n=1), and bifid vagina with vaginal atresia (n=1).
Surgical techniques included:
Urinary function was assessed through validated questionnaires (CBBDQ, IBSS, ICIQ-SF123) and clinical evaluation of urinary symptoms. Statistical analyses included chi-square and Fisher–Freeman–Halton tests, with p<0.05 considered significant.
RESULTS
Most patients demonstratedpreserved urinary function:
Clinically diagnosed lower urinary tract dysfunction (LUTD) was identified in 7 of 51 patients (13.7%).
A substantial majority (86.3%) reportedno urinary symptoms, with enuresis, urgency, or daytime leakage occurring rarely (each ≤3.9%).
Across all surgical groups, there wereno statistically significant differencesin:
All statistical tests yieldedp > 0.05, indicating thatno surgical technique demonstrated superiority or increased riskof urinary dysfunction.
CONCLUSIONS
Long-term urinary outcomes after urogenital sinus surgery in patients with DSD are generally favorable, withno significant differences among surgical techniques. These findings support the notion that the choice of surgical method may be guided primarily by anatomical considerations and genital reconstruction goals rather than concerns about long-term urinary function. This study represents one of the most comprehensive regional datasets on urinary outcomes following DSD surgery.
16:50 - 17:00
SN03-2 (NP)
Aysegül AKBULUT 1, Merve DEDE 2, Tuğçe Merve ORBAY ERECAN 2, Mehmet Uğur YILMAZ 2, Nizamettin KILIÇ 2 and Mehmet Emin BALKAN 2
1) Uludag University Medical Faculty, Paediatric surgery /division of paediatric urology, Bursa, TÜRKIYE - 2) Bursa Uludag University Faculty of Medicine, Department of Pediatric Surgery Division of Pediatric Urology, Bursa, TÜRKIYE
PURPOSE
Urethral duplication is a rare congenital anomaly with multiple anatomical variants and variable clinical presentations. Several surgical techniques have been described, but no single method is ideal. This study aimed to describe the characteristics, presentation, and management of a large single-center pediatric cohort.
MATERIAL AND METHODS
Medical records of 14 male patients treated for urethral duplication between 2014 and 2025 were reviewed retrospectively. Data included age, clinical presentation, Effman classification, surgical technique, number of procedures, and follow-up duration. Preoperative or intraoperative retrograde urethrography was used to determine the type of duplication.
RESULTS
All patients were male. Duplication types included: type IA (blind-ending midline channel, n=4), type IB (urethral-origin blind-ending channel, n=4), type IIA2 (two urethras from a common bladder neck, n=4), type IIA2-Y (ventral urethra opening in perineum, n=1), and one case of bifid glans with duplicate urethra not fitting Effman classification. Associated anomalies included penoscrotal hypospadias (n=5), subcoronal hypospadias (n=2), anorectal malformation (ARM, n=2), and vesicoureteral reflux (VUR, n=1). The mean number of surgical procedures was 2, with a mean follow-up of 5.2 years. Urethral duplication was incidentally found in two patients with ARM, four during hypospadias repair, and one during undescended testis repair. Surgical management included excision of the accessory urethra (n=9), urethroplasty using pedicled flap (Duckett tube, n=2), urethrourethroplasty (n=1), and excision of accessory and hypoplastic urethra with glans wedge resection and corpus cavernosa fusion in the case with bifid glans (n=1).
CONCLUSIONS
Urethral duplication is a rare congenital anomaly with highly variable clinical presentations, ranging from silent to specific complaints. Treatment should be individualized based on anatomical type, symptoms, associated anomalies, and surgeon experience, as no standard management exists. Early recognition and tailored surgical planning are essential to optimize outcomes in this heterogeneous patient population.
17:00 - 17:10
SN03-3 (NP)
Irene IJGOSSE 1, Aart J. KLIJN 2, Ruud WORTEL 2, Leendert LOOIJENGA 1, Rogier SCHROEDER 2, Ralph OUDE OPHUIS 3, Margreet VEENING 1, Lideke VAN DER STEEG 1, Sruthi SRIRAM 1 and Marianne VAN DE WETERING 1
1) Prinses Maxima Centrum voor kinderoncologie, Pediatric oncology, Utrecht, NETHERLANDS - 2) UMC Utrecht, Pediatric urology, Utrecht, NETHERLANDS - 3) UMC Utrecht, Voortplantings geneeskunde, Utrecht, NETHERLANDS
PURPOSE
Pediatric cancer survival now exceeds 80%, yet gonadotoxic chemotherapy causes high risk for infertility in 25-35% of male survivors. While semen cryopreservation is established for pubertal boys, prepubertal patients require preservation of the spermatogonal precurser cells, the stem cells. We present outcomes from a systematic national oncofertility program integrating testicular tissue cryopreservation into routine prepubertal cancer care.
MATERIAL AND METHODS
Between 2021-2025, newly diagnosed male oncology patients were risk-stratified according to international PanCareLIFE guidelines. All high-risk patients (n=410) received structured counseling by a multidisciplinary team including pediatric oncologists, a fertility nurse practitioner, and pediatric urologists. Of patients choosing fertility preservation (n=234, 57%) 152 (post)pubertal boys opted for semen preservation. 82 prepubertal boys agreed on unilateral open trans-scrotal testicular biopsy during general anesthesia scheduled for port-a-cath placement. With informed consent, 15% of tissue was allocated for spermatogonial stem cell (SSC) research; 85% was cryopreserved. Tissue viability and histopathology were assessed for research samples. Surgical complications were systematically evaluated immediately post-operatively and at structured follow-up intervals
RESULTS
All 82 testicular biopsies yielded tissue suitable for cryopreservation with volumes correlating to testicular size. Histological examination confirmed presence of spermatogonial stem cells in all samples allocated for research. No intra-operative complications occurred. Post-operatively, one patient (1.2%) developed a self-limiting scrotal hematoma requiring no intervention. No testicular atrophy, infection, delayed wound healing, or long-term adverse events were documented. The procedure added minimal time to anesthesia, and cancer treatment initiation was not delayed in any case.
CONCLUSIONS
Systematic implementation of a multidisciplinary oncofertility program successfully counseled 57% of high-risk patients. Unilateral testicular tissue biopsy in prepubertal boys is safe (1.2% complication rate), achieves 100% cryopreservation success, and does not delay cancer treatment. This standardized approach demonstrates feasibility of fertility preservation and supports SSC cryopreservation as standard-of-care in pediatric oncology centers.
17:10 - 17:20
SN03-4 (NP)
Tabea EICHLER 1, Vivienne SOMMER 1, Raphael N. VUILLE-DIT-BILLE 1 and Martina FRECH 2
1) University Children's hospital Basel, Paediatric Urology/Surgery, Basel, SWITZERLAND - 2) University Children's Hosptial Basel, Paediatric Urology/Surgery, Basel, SWITZERLAND
PURPOSE
Posterior urethral valves (PUV) are the main cause of lower urinary tract obstruction in boys. Most cases are detected prenatally or in early infancy, but more than one third of patients are only diagnosed later (Brownlee et al. J Pediatr Surg 2019; 54: 318-21). The aim of this study is to examine the correlation between persistent lower urinary tract symptoms (LUTS) and PUV in older boys.
MATERIAL AND METHODS
We conducted a retrospective analysis of all boys older than 7 years, who underwent diagnostic cystoscopy for persistent LUTS or recurring urinary tract infections (UTI) from January 2018 until September 2025. Cystoscopy was indicated after unsuccessful conservative treatment. PUV were defined as a narrowing of the urethra by at least 30% at typical localization.
RESULTS
A total of 55 boys older than 7 years underwent diagnostic cystoscopy between January 2018 and September 2025 due to unsuccessful conservative treatment of their symptoms. In 49 of these boys, PUV were detected and treated in the same surgery. 44 (89.8%) of those patients initially showed a form of LUTS (incontinence, enuresis, dysuria, voiding difficulties or urinary retention). 32 (65.3%) showed any abnormality in ultrasound, while there were 7 patients (14.3%) that didn’t show any abnormality in ultrasound or uroflowmetry. After surgical treatment, 4 patients were lost to follow up. Among the remaining boys, 25 (55.6%) experienced complete resolution of their symptoms within the first 6 months post-surgery. 7 patients (15.6%) showed no improvement at all. In the rest a partial resolution of symptoms could be seen.
CONCLUSIONS
PUV are an often-underestimated cause of LUTS in older boys. Functional diagnostics, such as uroflowmetry, should be employed as early as possible, while ultrasound should be interpreted with caution, as they may not reveal the presence of PUV. Cystoscopy should be considered in patients with unsuccessful conservative treatment and remains crucial for symptom improvement, although full resolution of symptoms may still take considerable time after surgical treatment.
17:20 - 17:30
SN03-5 (NP)
Eskinder SOLOMON 1, Pankaj MISHRA 1, Jo CLOTHIER 2 and Massimo GARRIBOLI 1
1) Evelina Children's Hospital, Paediatric Urology, London, UNITED KINGDOM - 2) Evelina Children's Hospital, Paediatric Nephrology, London, UNITED KINGDOM
PURPOSE
To review and present the video urodynamics (VUD) presentations of infants with posterior urethral valves (PUV)
MATERIAL AND METHODS
We retrospectively reviewed the VUD findings of 38 infants born with PUV post-valve resection. From least two-fill cycles, we documented the presence of detrusor overactivity (DO, detrusor contraction with associated guarding as determined by EMG and/or fluoroscopy), cystometric capacity, end-fill Pdet, compliance (C = capacity/end-fill Pdet) and evidence of vesico-ureteric reflux (VUR). From the voiding phase (urine output with a relaxed external urinary sphincter), we determined the maximum voiding Pdet (PdetMax), post-void residual (PVR) as well as radiographic evidence of bladder neck obstruction (BNO) and dysfunctional voiding (DV)
RESULTS
The mean (+sd) period between birth and PUV resection and the VUD was 17 (+13) days and 248 (+172) days respectively. Voiding data was acquired in 35 boys (in the other 5, the study was terminated when the infused bladder volume exceeded 150% of the expected bladder capacity). The VUD findings are given in the table below.
|
UD parameter |
n/Mean (+SD) |
|
|
Filling phase |
||
|
DO |
30/38 (79%) |
|
|
Peak DO (PDOPeak) |
75 (+61) cmH2O |
|
|
Capacity |
81 (+50) ml |
|
|
End-fill Pdet |
6(+5) cmH2O |
|
|
Compliance (C) |
14.7 (+27) ml/cmH2O |
|
|
VUR |
19/38 |
|
|
Voiding phase |
||
|
Voiding data acquired |
35/38 |
|
|
PdetMax |
BNO +ve |
BNO -ve |
|
n=14 151 (+67) cmH2O |
n=21 86.5 (+43) cmH2O |
|
|
DV |
25/35 |
|
|
VUR |
21/35 |
|
|
PVR |
32 (+44) ml |
|
CONCLUSIONS
DO and DV were the most common urodynamic findings. It is likely the prevalence of DV will decrease as voiding becomes more coordinated with age. However, the typically high-pressure nature of the DO suggests it is likely secondary to outlet obstruction during key stage of development rather than a dysfunction the infants will outgrow. VUR and BNO were also observed in almost half of the cohort. The prevalence and severity of bladder dysfunction in infants with PUV warrants close monitoring and potentially proactively management.