MP56-09 UPPER URINARY TRACT AFFECTION AFTER MANAGEMENT OF BLADDER EXSTROPHY A LONG-TERM FOLLOW UP

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Ureter (including Pyeloplasty) and Bladder Reconstruction (including fistula), Augmentation, Substitution, Diversion II1 Apr 2016MP56-09 UPPER URINARY TRACT AFFECTION AFTER MANAGEMENT OF BLADDER EXSTROPHY A LONG-TERM FOLLOW UP Ahmed Shoukry, Mahmoud Ragab, Mohamed El Sheemy, Ahmed Shouman, Wasim Abouella, Karim Daw, Mohamed El Ghonimy, Hisham El Ghamrawy, Hani Morsi, and Hisham Badawy Ahmed ShoukryAhmed Shoukry More articles by this author , Mahmoud RagabMahmoud Ragab More articles by this author , Mohamed El SheemyMohamed El Sheemy More articles by this author , Ahmed ShoumanAhmed Shouman More articles by this author , Wasim AbouellaWasim Abouella More articles by this author , Karim DawKarim Daw More articles by this author , Mohamed El GhonimyMohamed El Ghonimy More articles by this author , Hisham El GhamrawyHisham El Ghamrawy More articles by this author , Hani MorsiHani Morsi More articles by this author , and Hisham BadawyHisham Badawy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.621AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Many studies discussed continence and cosmetic results after bladder exstrophy management however few commented on upper urinary tract affection. We present our results regarding long-term follow up after management of bladder exstrophy patients with special emphasis on upper urinary tract affection. METHODS We reviewed our retrospective bladder exstrophy database and using direct telephone contact, patients were scheduled for a follow up visit. 32 patients responded, 23 male and 9 females. Mean age 8.7 ± 6.4 years, mean follow up 8 ± 5.2 years, mean age at first operation 206 ± 314 days. An average number of 3.4 ± 2.3 operations were performed for the patients. Ascending cystourethrogram (ACU) with micturating cystourethrogram (MCU), pelvic and abdominal ultrasound, serum creatinine and urine analysis and culture were performed for all patients. Statistical differences between groups were tested using Chi-square, Nonparametric Mann Whitney test and Friedman test. A p-value less than 0.05 was considered statistically significant. RESULTS 23 (72%) patients underwent bladder neck reconstruction (BNI), 19 (59%) underwent augmentation ileocystoplasty (AI), 5 (16%) underwent ureterovesical implantation (UVI), 22 (69%) of the patients underwent osteotomy, 9 (28%) patients were totally or partially continent, 3 patients (9%) underwent Mitrofanoff, 8 (25%) patients had a penopubic fistula. 18 patients (56%) had urinary tract infection, 24 (75%) patients showed no backpressure changes, 3 (9%) patients showed unilateral backpressure changes, 5 (16%) patients showed bilateral backpressure changes. ACU and MCU results showed 8 (25%) patients had no refluxing ureters, 15 (47%) patients showed unilateral reflux and 9 (28%) patients showed bilateral reflux. Mean serum creatinine level 0.71 ±0.22 mg/dl. Presence of hydronephrosis was statistically significant correlated with less number of operations 0.02 p value. Patients who did not perform AI showed statistically significance higher incidence of refluxing ureters p-value = 0.01. Mitrofanoff procedure showed statistically significant better results regarding continence p-value = 0.001. Age at first intervention, number of operations, AI, BNR did not show any statistically correlation with serum creatinine level or infection. CONCLUSIONS Upper urinary tract follow up is of utmost importance, augmentation ileocystoplasty and Mitrofanoff urinary diversion can be a quiet combined savior procedure for the upper urinary tract and an acceptable continence results. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e747-e748 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Ahmed Shoukry More articles by this author Mahmoud Ragab More articles by this author Mohamed El Sheemy More articles by this author Ahmed Shouman More articles by this author Wasim Abouella More articles by this author Karim Daw More articles by this author Mohamed El Ghonimy More articles by this author Hisham El Ghamrawy More articles by this author Hani Morsi More articles by this author Hisham Badawy More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...