You have accessJournal of UrologyCME1 Apr 2023MP52-17 DEMOGRAPHICS AND OUTCOMES OF BLADDER AUGMENTS IN ADULTS FOR NEUROGENIC BLADDER Rishabh Simhal, Kerith Wang, Maria D'Amico, Courtney Capella, Radhika Ragam, Yash Shah, Joon Yau Leong, Alana Murphy, and Patrick Shenot Rishabh SimhalRishabh Simhal More articles by this author , Kerith WangKerith Wang More articles by this author , Maria D'AmicoMaria D'Amico More articles by this author , Courtney CapellaCourtney Capella More articles by this author , Radhika RagamRadhika Ragam More articles by this author , Yash ShahYash Shah More articles by this author , Joon Yau LeongJoon Yau Leong More articles by this author , Alana MurphyAlana Murphy More articles by this author , and Patrick ShenotPatrick Shenot More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003300.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Appendicovesicostomy (AV) or augmentation enterocystoplasty (AE) for neurogenic bladder (NB) are infrequently performed in adult patients. Outcomes and safety data have been limited to case series. Here, we aim to better elucidate the patient demographics and surgical outcomes for AV and AE using the National Surgical Quality Improvement Project (NSQIP). METHODS: AV and AE for NB were identified in NSQIP from 2006-2020 using CPT and ICD codes, and miscoded cases were filtered. Patients with concurrent radical cystectomy, pelvic exenteration, or continent urinary diversion/neobladder CPTs were excluded. Patients were then grouped by whether they had AV, AE, or both AV+AE. Patient baseline characteristics and 30-day outcomes were calculated and described. RESULTS: 131 cases (39 AV, 72 AE, and 20 AV+AE) of AV and/or AE for neurogenic bladder were identified. Patients undergoing these procedures were young (mean age of 38), mostly female (66%), and mostly white (73%). The most common medical comorbidities were hypertension (21.4%) and diabetes (8.4%). Of note, 9.2% of patients had preoperative wound infections and 5.6% were chronically on steroids. The cohort had significant surgical risk factors; 44% of patients were either partially or totally functionally dependent, and 73% had an ASA class of 3 (severe disturbance) or higher. 24% of patients had a minor 30-day complication, most commonly urinary tract infection (11.5% overall, 10.3% in AV, 13.9% in AE, and 5.0% in AV+AE), superficial surgical site infection (9.2% overall, 10.3% in AV, 8.3% in AE, and 10.0% in AV+AE), pneumonia (3.1% overall, 0.0% in AV, 4.2% in AE, and 5.0% in AV+AE), or bleeding requiring transfusion (3.1% overall, 2.6% in AV, 2.8% in AE, and 5.0% in AV+AE). 13% of patients had a major 30-day complication, most commonly sepsis (6.1% overall, 2.6% in AV, 9.7% in AE, and 0.0% in AV+AE) or pulmonary embolism (2.3% overall, 2.6% in AV, 1.4% in AE, and 5.0% in AV+AE). The 30-day reoperation rate was 2.8% in AEs resulting in a total of 1.5% of cases. 30-day readmission rate was 15.7% overall with 10.5% AVs, 23.1% AEs, and no AV+AEs returning to the hospital. There were no recorded 30-day mortalities. CONCLUSIONS: This is the largest study done on AV and AE. These procedures had high complication and readmission rates, which may in part be due to preoperative patient risk factors. Of note, our average patient age and complication rate were lower than previously published studies from NSQIP which may reflect our filtering of mislabeled cases. Further studies are needed to better characterize these patients. Source of Funding: n/a © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e709 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rishabh Simhal More articles by this author Kerith Wang More articles by this author Maria D'Amico More articles by this author Courtney Capella More articles by this author Radhika Ragam More articles by this author Yash Shah More articles by this author Joon Yau Leong More articles by this author Alana Murphy More articles by this author Patrick Shenot More articles by this author Expand All Advertisement PDF downloadLoading ...