PD02-08 BLADDER CAPACITY AND GROWTH IN CLASSIC BLADDER EXSTROPHY: A NOVEL PREDICTIVE TOOL

Abstract

You have accessJournal of UrologyCME1 May 2022PD02-08 BLADDER CAPACITY AND GROWTH IN CLASSIC BLADDER EXSTROPHY: A NOVEL PREDICTIVE TOOL Tamir Sholklapper, Mahir Maruf, Jiafeng Zhu, Jason Michaud, Mohammad Zaman, John Jayman, Roni Manyevitch, Rachel Davis, Wayland Wu, Thomas Harris, Heather DiCarlo, Gayane Yenokyan, and John Gearhart Tamir SholklapperTamir Sholklapper More articles by this author , Mahir MarufMahir Maruf More articles by this author , Jiafeng ZhuJiafeng Zhu More articles by this author , Jason MichaudJason Michaud More articles by this author , Mohammad ZamanMohammad Zaman More articles by this author , John JaymanJohn Jayman More articles by this author , Roni ManyevitchRoni Manyevitch More articles by this author , Rachel DavisRachel Davis More articles by this author , Wayland WuWayland Wu More articles by this author , Thomas HarrisThomas Harris More articles by this author , Heather DiCarloHeather DiCarlo More articles by this author , Gayane YenokyanGayane Yenokyan More articles by this author , and John GearhartJohn Gearhart More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002517.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Bladder capacity (BC) is an important metric in the management of patients with classic bladder exstrophy (CBE) and is used to clinically estimate likelihood of continence and determine eligibility for continence procedures, such as bladder neck reconstruction. The Koff equation, which estimates BC from patient’s age has limited applicability in the exstrophy population. We sought to develop a model of maximum bladder capacities for those with CBE using readily available clinical variables. METHODS: An institutional database of CBE patients was reviewed for those who have undergone annual gravity cystogram 6 months after bladder closure. Linear mixed effects models with random intercept and slope were used to construct models predicting log transformed BC and were compared with adjusted R2, Akaike Information Criterion, and cross-validated mean square error. The final model includes outcome of primary closure, sex, log-transformed age at successful closure, time from successful closure, and interaction between outcome of primary closure and log-transformed age at successful closure as the fixed effects with random effect for patient and random slope for time since successful closure. RESULTS: In total, 369 patients (107 female, 262 male) with CBE had at least one BC measurement after bladder closure. Patients had a median of 3 annual measurements (range 1-10). The log bladder capacity increases with the age at cystographic evaluation. Other factors associate with capacity include sex, outcome of primary bladder closure, age at successful bladder closure and age at evaluation. A web based interactive CBE bladder growth nomogram (Figure 1) may be found at https://exstrophybladdergrowth.shinyapps.io/be_app/. CONCLUSIONS: Using readily accessible patient and disease related information, the bladder capacity model in this study provides an accurate prediction of bladder capacity. Using clinical factors specific for the exstrophy population should be considered over age-based Koff equation estimates. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e38 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tamir Sholklapper More articles by this author Mahir Maruf More articles by this author Jiafeng Zhu More articles by this author Jason Michaud More articles by this author Mohammad Zaman More articles by this author John Jayman More articles by this author Roni Manyevitch More articles by this author Rachel Davis More articles by this author Wayland Wu More articles by this author Thomas Harris More articles by this author Heather DiCarlo More articles by this author Gayane Yenokyan More articles by this author John Gearhart More articles by this author Expand All Advertisement PDF DownloadLoading ...