ESPU-Nurses Meeting on Friday 19, June 2026, 10:50 - 12:40
11:50 - 12:00
SN09-1 (NP)
Georgia SETCHELL 1, Emily GOLDING 2, Imran MUSHTAQ 3, Navroop JOHAL 3, Karen RYAN 3 and Kristina SOON 4
1) Anglia Ruskin University, Psychology, London, UNITED KINGDOM - 2) University of Surrey, Clinical Psychology, Guildford, UNITED KINGDOM - 3) Great Ormond Street Hospital for Children NHS Foundation Trust, Urology, London, UNITED KINGDOM - 4) Great Ormond Street Hospital for Children NHS Foundation Trust, Psychological and Mental Health Services, London, UNITED KINGDOM
PURPOSE
Children and young people with complex urological anomalies are known to experience significant psychological and social challenges (Dellenmark-Blom et al, Qual Life Res 2019; 28:1389-1412).
Stigma is known to predict later psychological and social difficulties as well as disengagement from medical care in young people with long-term medical conditions (Rueda et al, BMJ Open 2016;6) resulting in poorer physical and mental health outcomes.
One-off, one-hour long groups for age-matched patients and separately for their parents were run as part of a specialist multi-disciplinary clinic for paediatric bladder exstrophy-epispadias complex, cloacal exstrophy and hypospadias which aimed to address feelings of isolation and devaluation due to their urological condition and discomfort in talking openly about their illness-related experiences.
MATERIAL AND METHODS
Participants completed a five-item survey with likest scale responses from 1(poor) to 5(excellent) based on the Group Session Rating Scale (Quirk et al, Coun Psychother Res 2013; 13:194-200) as well as open-ended questions about their experience of the group.
Participants were also asked to contribute to a "Book of Wisdom" in which they were asked to write their advice for patients/parents who were unable to attend or who were early in their experience of urological anomalies.
Fifty of 70 patient attenders completed surveys of whom 41 were male and 29 female with a mean age of 13-0 years. Thirteen parents provided feedback about the parent group
RESULTS
Mean ratings on all patient and parent scales ranged between 4.2 (SD=.76) and 4.7 (SD=.38). Thematic analysis of qualitative feedback about group experience revealed common themes of feeling a reduction in sense of isolation and defectiveness, feeling heard and learning from others' experiences. Most common pieces of advice in the Books of Wisdom were to feel proud about themselves and their illness journey, to know that they are not alone and to work collaboratively with their healthcare providers. Also of note was the high level of positive experience from male and adolescent patients; patients typically difficult to engage in psychological care.
CONCLUSIONS
Preliminary results indicated that the groups were well-received and addressed stigma-related issues, as expected, providing support for continuation of service. Further research will aim to measure stigma change directly as well as addressing low attendance in patients with minoritized ethnicities.
12:00 - 12:10
SN09-2 (NP)
Fiona MARKS, Claire FOSTER, Massimo GARRIBOLI and Eskinder SOLOMON
Evelina Children's Hospital, Paediatric Urology, London, UNITED KINGDOM
PURPOSE
Idiopathic stress urinary incontinence (ISUI) is a rare yet distressing condition affecting adolescent girls, influenced by various factors that may impact its severity and management. This study aims to assess the associations between Body Mass Index (BMI), bladder hypermobility, and the response to physiotherapy within this population.
MATERIAL AND METHODS
We conducted a retrospective review of clinical and urodynamic data from 20 girls diagnosed with ISUI. BMI was recorded, and percentiles were assessed using World Health Organization charts. The response to physiotherapy was graded utilizing the Patient's Global Impression of Improvement (PGI-I) scale, with scores ranging from 1 (Very Much Better) to 7 (Very Much Worse). Video urodynamics were performed in 14 participants. Bladder hypermobility was diagnosed if the bladder neck at rest was located below the inferior border of the pubic symphysis during end-fill while standing.
RESULTS
The median presenting age was 12 years (range: 10 to 15 years). The median BMI percentile among the girls was the 80th (range: 12th to 99th percentiles). Eight out of 20 patients reported a PGI-I score of 1 to 3 (indicating improvement), with a median BMI at the 80th percentile. Conversely, 12 girls reported scores greater than 4 (indicating no improvement or worsening), also with a median BMI of the 80th percentile. Notably, 12 girls exhibited significant bladder hypermobility, while intrinsic sphincter deficiency was evident in 2 patients.
CONCLUSIONS
Our findings suggest that bladder hypermobility is the predominant mechanism underlying of ISUI. The typically elevated BMI among these girls may exacerbate the condition, as less than half of the participants demonstrated a positive response to physiotherapy.
12:10 - 12:20
SN09-3 (NP)
Claire FOSTER, Massimo GARRIBOLI, Pankaj MISHRA, Arash TAGHIZADEH and Anu PAUL
Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, Paediatric Urology, London, UNITED KINGDOM
PURPOSE
Ileal chimney or Ileovesicostomy (IV) surgery was implemented within our service as an alternative intervention to support safe bladder pressures and facilitate effective bladder emptying in cases where exisiting bladder management strategies were insufficient and ileocystoplasty, vesicostomy, and Mitrofanoff procedures were deemed inappropriate for the patient.
MATERIAL AND METHODS
Patients requiring surgical bladder management were reviewed in our multidisciplinary team meeting, and surgical options such as ileocystoplasty, ileal chimney, Mitrofanoff and vesicostomy were considered. Decision making was guided by a comprehensive assessment of diagnosis, previous and planned treatments or surgeries, social context, development and cognitive status, age, and prior/anticipated complications.
Preoperative preparartion involved a surgical consultation to explore available options, followed by one or two counselling sessions with the clinical nurse specialist/ advanced nurse practitioner team. Theses sessions focused on stoma care, adapting daily activities to life with a stoma, and identifying the optimal stoma site on the abdomen.
Before surgery, patients were assessed by an adult stoma care nurse to confirm stoma position, mark the patient, and provide appropriate appliances. Postoperatively, patients received daily reviews to support stoma care education and promote independence.
RESULTS
5 patients over 2 year (2024-2025). 3 Boys. Age range 6-16rys.
Inital postopertive challenges included stoma bag leaks in several patients, typically due to infrequent drainage or stoma bag folding, leading to urine pooling aroun the stoma site. These issues were effectively resolved through education on regular bag drainage and proper bag positioning.
One patient experienced urethral leakage following surgery and required surgical revision of the stoma.
Two patients presented with mucus-related complications and were successfully taught bladder washout to manage symptoms.
CONCLUSIONS
IV formation constitutes a pragmatic surgical alternative for patients in whom alternative continent surgical bladder management is unsuitable. Rigorous preoperative preparation is imperative to ensure that both the patient and their family acquire a comprehesive postoperative stoma management. Patient education should underscore the necessity of consistent stoma bag empyting to mitigate the risk of leakage, and emphasise the avoidance of bag folding, which predisposes to urine pooling and subsequent peristomal skin complications.
12:20 - 12:30
SN09-4 (NP)
Kay RUTH, Claire FOSTER, Catrin GRIFFITHS, Eleanor PAGE, Ellie ADAMS, Fiona MARKS and Poppy ABOUD
Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, Urology, London, UNITED KINGDOM
PURPOSE
Performing catheterisation in school settings is essential for many children with neurogenic or functional bladder conditions, yet school staff often have limited training opportunities. Traditional in-person teaching provided by tertiary care service CNS, can be resource-intensive particularly for centres covering a large geographical area. In order to overcome this limitation, we developed a hybrid virtual and in person catheter training model to support schools while maintaining safety and confidence in catheter care. We are presenting our model and evaluate its outcome and impact on our service.
MATERIAL AND METHODS
We implemented a structured 30-minute virtual training session delivered by the paediatric urology nursing team to school staff. This was supported by a standardised catheterisation booklet sent in advance, outlining the indication for catheterisation, required equipment, a step-by-step explanation of the procedure, and common troubleshooting guidance. Following a single virtual session, parents or carers were asked to attend the school to demonstrate the child-specific practical technique. Contact details for the nursing team were also provided to ensure staff could seek further advice or clarification if needed.
RESULTS
Since the end of 2023, we have successfully trained 35 nurseries and schools in paediatric catheterisation using the Hybrid-Teaching model. No patients’ concern or complication have occurred following the training.
By adapting our practice, the team has saved roughly 122 hours which was re-allocated within our team to hold additional clinics or review ward patients. Across the review period so far, virtual training sessions accounted for a total of 17.5 hours, compared with 140 hours required for equivalent face-to-face delivery. Based on an estimated cost of £160 per half day for a top Band 7 nurse (including all employer contributions and Inner London HCA), the change in delivery has generated an approximate saving of £4,880 per year.
CONCLUSIONS
The hybrid catheter-teaching model is a valid and safe method to deliver training for school personnel remotely reducing cost and time required from the tertiary service nurse team. It can be a solution for services with high demand and allows supporting large geographical areas.
12:30 - 12:40
SN09-5 (NP)
Maria Fernanda RUIZ ALBARRAN 1, Cristina Marcela MARÍN RODRÍGUEZ 2, Rosa María ROMERO RUIZ 3, Maria Jose MOYA JIMÉNEZ 1, Rocio GRANERO CENDÓN 1, Ana ACEMEL ACEMEL 1 and Isabel CASAL BELOY 3
1) Virgen del Rocío University Hospital, Pediatric Surgery, Seville, SPAIN - 2) Virgen del Rocío University Hospital, Pediatric Surgery Department, Pediatric Urology Unit, Seville, SPAIN - 3) Virgen del Rocío University Hospital, Pediatric Surgery Department, Pediatric Urology Unit,, Seville, SPAIN
PURPOSE
The use of electrotherapy is increasingly common in pediatrics to treat urinary dysfunction, intestinal dysfunction, and pain. Its benefits are well documented, but there is limited information regarding its adverse effects. The aim of this study is to describe the complications observed.
MATERIAL AND METHODS
We conducted a retrospective review of all patients treated with sacral electrotherapy (TENS-S), tibial electrotherapy (T-TENS), and suprapubic electrotherapy (SS-TENS) during the 2023-2024 period. Demographic data, diagnoses, and adverse effects were analyzed. The therapy was applied either in the hospital or at home. Complications were classified according to the CTCAE (Common Terminology Criteria for Adverse Events).
RESULTS
We included 175 patients (mean age 12.3 years). Patients were categorized based on the indication for therapy: pelvic, perineal, or genital pain (7 patients); intestinal dysfunction (32 patients); and bladder dysfunction (136 patients). Adverse effects were reported in 12.5% of patients with intestinal dysfunction (n=4, urinary urgency and incontinence, CTCAE 1-2), in 10.3% of those with bladder dysfunction (n=14, fecal urgency, CTCAE 1-2), and in 14% of children treated for pain (n=1, fecal urgency, CTCAE 1-2). Additionally, 3 patients developed dermatitis at the site of transcutaneous patch application (CTCAE 1). No severe adverse effects were recorded. No patient had to discontinue TENS therapy due to adverse events. Among the total number of patients with fecal urgency (15), 3 presented associated fecal incontinence. In 2 of these cases, symptoms resolved by reducing the frequency of TENS sessions. In the third case, in addition to reducing TENS frequency (3 times per week), transanal irrigations were initiated before device use. Urinary urgency was not associated with incontinence and was managed with standard urotherapy guidelines.
CONCLUSIONS
Despite the advantages of TENS, it is essential to recognize and monitor its potential adverse effects. TENS applied to one system may affect another. Understanding these effects is crucial to provide comprehensive management and adequately inform patients about the benefits and risks of the therapy. Further studies are needed to optimize the safety and effectiveness of TENS.