Parallel Meeting on Thursday 18, June 2026, 11:20 - 12:20
11:20 - 11:25
T&T-1 (SP)
Sadaf ABA UMER, Muhammad ZAKIR, Bashir AHMED and Sajid SULTAN
Sindh Institute of Urology & Transplantation, Philip G. Ransley Department of Paediatric Urology, Karachi, PAKISTAN
PURPOSE
In resource-limited settings, pediatric urologists often rely on creativity and adaptability to overcome constraints in equipment and infrastructure. Jugaad reflects this spirit of economical innovation, enabling safe, effective, and practical solutions to deliver quality care for children. Material and methods
Few constraints in equipment like unavailability of grasping forceps to retrieve proximally migrated JJ stent in ureter and unavailability of pyeloplasty stent (sellae stent) are being faced especially in developing countries and rural settings. Tips to solve these problems are presented.
RESULTS
A 4-6 Fr infant feeding tube, depending on the child's age and ureteral caliber, can be used as an improvised pyeloplasty stent. Additional side holes are created along the proximal segment of the tube (approximately 3-5 cm from the tip) intended to lie within the renal pelvis to facilitate adequate drainage. The distal end of the tube is passed across the pyeloureteral junction (PUJ) anastomosis into the proximal ureter, while the proximal portion is positioned within the renal pelvis. The tube is then exteriorized to function as an external stent. This technique serves as a safe and effective alternative to a standard stent during pyeloplasty in resource-limited settings.
CONCLUSIONS
Jugaad in paediatric urology highlights how thoughtful, low-cost innovations can safely bridge gaps in resource-limited settings. Constraints of resources should not be a handicap to better management.
11:25 - 11:30
T&T-2 (SP)
Alexander SPRINGER
Medical University Vienna, Paediatric Urology, Vienna, AUSTRIA
SUMMARY
The optimal duration of urinary diversion following ureteric reimplantation (UR) is not standardized. Although early removal of urinary catheters is generally recommended, the literature and epidemiologic data remain inconclusive. For example, in Germany, the mean length of hospital stay after open UR in children decreased from 12 to 10 days between 2019 and 2024 (Schmedding, 2026). Since 2014, our institutional practice has been to place an 8-Fr suprapubic catheter following UR and remove it after 48 hours. Based on our experience with more than 150 procedures, we conclude that 48 hours of suprapubic bladder drainage is safe and sufficient. Length of hospital stay after UR appears to be influenced primarily by postoperative pain control and duration of urinary drainage. Prolonged drainage therefore seems unnecessary and may increase patient burden and healthcare costs. I realize this may seem trivial, and most of us practicing in healthcare systems where cost efficiency is a priority would likely agree. However, there are still centers in Europe where children remain hospitalized for prolonged periods after ureteric reimplantation, and urinary catheters are routinely removed only after 7 days, often following cystogram. I encounter this practice frequently. Therefore, I believe these findings are worthwhile to report.
11:30 - 11:35
T&T-3 (SP)
Salvatore CASCIO
Children's University Hospital, Paediatric Surgery, Dublin, IRELAND
SUMMARY
For 18 years a laparoscopic assisted PD catheter insertion has been used by the first author with a single 5 mm Port at the umbilicus using an inverted J incision and a Seldinger technique, with either a 14 or 16 Fr introducer kit. In October 2024, the technique was modified to include fixation of the catheter to the lower anterior abdominal wall using an Endoclose device (Autosuture, Covidien). Four patients- 3 boys aged 1, 2, 9 and 10 years- underwent PD catheter insertion using the modified technique. All patients were in End Stage Kidney Disease due to posterior urethral valves and renal dysplasia (2), nephronophthisis (1) and renal dysplasia (1). All 4 cases underwent successful placement of a PD catheter with an absorbable suture. Three patients had no complications whilst one patient required laparoscopic repositioning of the PD catheter and fixation to the abdominal cavity with a non-absorbable suture (2-0 Ethibond) at a mean follow up of 11.8 months. The Pedfix technique provides excellent cosmetic results, optimal pelvic visualization and fixation of the PD catheter to the lower anterior abdominal wall which minimizes the risk of catheter migration and blockage. These encouraging results need to be confirmed by a prospective study with longer follow up.
11:35 - 11:40
T&T-4 (SP)
Sonia PÉREZ-BERTÓLEZ
Hospital Sant Joan de Déu, Barcelona, SPAIN
SUMMARY
Rotation of the corpora cavernosa is a length-preserving technique applicable to ventral penile curvature, both in isolated curvature and in curvature associated with hypospadias. Dorsal plication techniques, although widely used, are associated with penile shortening. Ventral grafting represents an alternative but may require an additional surgical stage when treating hypospadias.
I will present a practical surgical tip based on medial rotation of the corpora cavernosa after longitudinal dorsal corporotomies, allowing effective correction of curvature while preserving penile length. Key technical steps and intraoperative decision-making will be highlighted to demonstrate how controlled corporal rotation can provide reliable straightening while avoiding the drawbacks of traditional plication techniques.
11:40 - 11:45
T&T-5 (SP)
Martin KAEFER
Riley Hospital for Children, Urology, Indianapolis, USA
SUMMARY
Enterocystoplasty is a reliable surgical option for providing adequate bladder capacity in patients with bladder dysfunction. However, if patients are not compliant with bladder emptying schedules, complications ranging from recurrent urinary tract infections with kidney injury to bladder perforation can occur. In such circumstance, conversion to a conduit diversion or removal of the augmented segment with placement of a chimney may be considered to minimize additional harm to the urinary tract. However, a simpler choice which we have favored is mobilization of the augmented segment so that it can be brought out as a stoma.
The procedure includes exposure of the augmented segment through a midline incision. Careful freeing of the dome of the augmented segment is undertaken while leaving the Mitrofanoff channel intact. The most mobile portion of the augment is then brought through the rectus muscle with close attention to the creation of a well-supported pooched (i.e. rosebud) stoma configuration. This last step is important to allow the stoma pouch to fit properly over the protruding stoma and collect urine effectively. Patients are instructed to catheterize the Mitrofanoff channel at least twice weekly as a means of irrigating the bladder.
This simple technique has been used in three patients with excellent bladder drainage. One additional advantage to this management strategy is the possibility of future simple stoma closure and resumption of daily catheterization should patient compliance improve and the patient once again desire to have a continent construct. Patients should thus be informed that this procedure can be deemed temporary and fully reversible.
11:45 - 11:50
T&T-6 (SP)
Bashir AHMED
Sindh Institute of Urology & transplantation, Philip G. Ransley Department of Paediatric Urology, Karachi, PAKISTAN
SUMMARY
A male neonate presented with a prenatal diagnosis of bilateral hydronephrosis, bilaterally dilated ureters and a full bladder with oligohydramnios identified at 34 weeks' gestation. Delivered by LSCS and did not pass urine leading to urethral catheterization. The bladder outflow obstruction was due to an ectopic ureterocoele (not recognized prenatally as it filled the bladder), associated with a cryptic duplex on the left with an atretic upper moiety ureter. The right ureter and lower moiety left ureter were both dilated. In view of a rising creatinine, bilateral mid lumbar loop ureterostomies were performed at the age of 3 weeks and he remained on ureterostomy drainage until the age of 7.5 years when he presented for reconstruction, with the unfavorable anatomy of mid-ureteric ureterostomies in dilated tortuous systems and the functional disadvantage of a high 24h urine volume with a previously obstructed bladder which had been dysfunctional all his life. He had never voided. Differential renal function was right 25%; left (lower moiety) 75%.
The ectopic ureterocoele was excised and trigonoplasty performed. The distal segment (below the ureterostomy) of the left lower moiety ureter (refluxing) underwent a limited extravesical reimplant and deployed as a left sided Mitrofanoff channel. The right ureterostomy was dismantled and the ureter (Simplex. Non-refluxing) completely divided. The left proximal ureter (lower pole) was then anastomosed end-to-end to the distal segment of the right ureter and a right (proximal ureter) to left (proximal ureter) trans-uretero-ureterostomy completed the upper tract reconstruction without tension or kinking.
At 6-year follow-up, the patient is asymptomatic, voiding normally, and using a Mitrofanoff channel at night, with stable renal function on imaging.
11:50 - 11:55
T&T-7 (SP)
Serdar TEKGÜL and Hasan Serkan DOĞAN
Hacettepe University, School of Medicine, Department of Urology, Division of Pediatric Urology, Ankara, TÜRKIYE
SUMMARY
Bladder neck reconstruction remains challenging due to the limited number of cases, varying surgeon experience, diverse patient presentations, and the complexities of outcome assessment. The primary aim is to restore urethral and bladder function, which can be achieved with techniques such as bladder neck slings, artificial urinary sphincters, and bladder neck injections.
This technique modifies the conventional approach (which narrows the bladder neck and lengthens the urethra) by harvesting a flap of detrusor muscle from the anterior bladder wall and placing it submucosally around the newly created bladder neck to enhance outlet resistance. The method is illustrated with planned videos and long-term results from 29 patients treated at multiple centers.
Ultimately, the most effective bladder neck reconstruction is tailored to the patient's needs, timing of surgery, potential need for bladder augmentation, and the likelihood of favorable long-term outcomes. These considerations are essential for determining indications and selecting appropriate candidates. The technique successfully reconstructs the bladder neck and achieves good mucosal coaptation in patients with isolated epispadias who have abnormal bladder necks and a compromised continence mechanism. The newly constructed bladder neck supports spontaneous urine flow and is easily catheterizable if necessary. While achieving continence can take time, adjunctive bladder neck injections have been shown to significantly improve continence if needed.