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Long-term follow up of GURS in children

Long-term follow up of GURS in children. T R TERRY UHL NHS TRUST. GURS in children. N=18 M:F 9:9 14 SB , 1PUV ,1 HAS ,1 SA, 1ESP FU 4-15 years , mean 8.9 years. GURS in children. Age at surgery 7-15 years, mean 12 years Cystoplasty n= 15 ; 1 ureterocystoplasty

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Long-term follow up of GURS in children

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  1. Long-term follow up of GURS in children T R TERRY UHL NHS TRUST

  2. GURS in children • N=18 • M:F 9:9 • 14 SB , 1PUV ,1 HAS ,1 SA, 1ESP • FU 4-15 years , mean 8.9 years

  3. GURS in children • Age at surgery 7-15 years, mean 12 years • Cystoplasty n= 15 ; 1 ureterocystoplasty • Mitrofanoff n= 15 ; 8 appendix counduits ; 5 of which split appendices, 1 bladder tube • MACE n=8 ; 1 caecostomy peg

  4. GURS in children • Monti’s n=8 ; 2 MACE, 6 Mitrofanoff’s • BNP n=11 ; 4 PS ,2 Kroop, 2CBN,1 PVS, 1 colposuspension, 1YDL • Bilateral re-implantation ureters n=2

  5. GURS in children • OUTCOME-SURGICAL REVISIONS • Stomal stenosis n=8 • Mitrofanoff revisions n=3 • Bladder neck revisions n=3 • Upper tract stones n=2 • Bladder stones n=2 • Spontaneous bladder rupture n=3(1 death)

  6. GURS in children • Morbidity issues • 1 patient died from spontaneous rupture of the augmented bladder (GS need to know) • 2 patients developed UT stones but none developed hydronephrosis • 3 stomal revision rate is high • 4 bladder neck procedures remain an issue

  7. GURS in children • Pregnancy in 19 year old SB treated 10 years previously with cystoplasty , MACE ,Mitrofanoff and Pippe Salle. • Required Caesarian section : key moves , use previous midline incision, push mesentery to one side and vertical uterine incision if bladder is high

  8. GURS in children • Catheter/pad usage • 3 indwelling catheters of both stomas • 12 on ISC of Mitrofanoff , 5 of MACE • 9 completely pad free • 6 using 1-3 pads /day mainly for soiling • 1 very wet at Mitrofanoff stoma , 3 occassionally wet

  9. GURS in children • QoL issues • None of those followed up wished that they had not had the GURS. All felt that it had benefited them in some way. 9 patients ,who previously were both wet and soiling ,were not using pads at a mean follow up of ~ 9 years

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