Page 1 - CUA2018 Abstracts - Endourology

2018 CUA AbstrACts

Podium Session 2: Pediatrics/Endourology

June 25, 2018; 1250–1350

POD–2.1 clinic and to those belonging to various invite–only social media support
The FOXY study: A randomized trial comparing the efficacy groups. Data was analyzed using descriptive statistics and Chi–squares.
and safety of fesoterodine and oxybutynin XL in children with Results: One hundred and forty–two survey responses were collected. The
overactive bladder majority of respondents were North American (82.5%), urban dwellers
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Sophie Ramsay , Elizabeth Naud , Katherine Moore , Stéphane Bolduc 1 (70.0%), and the mothers of the child (81%). Distal hypospadias was the
1 Centre Hospitalier Universitaire de Québec, CHUL, Université Laval, most common variant of the condition (68%). When asked if they plan to
Quebec City, QC, Canada disclose the repair to their child, 94% said “yes,” and of those, the optimal
Introduction: Oxybutynin has long been the only drug approved for the mean age of disclosure was 7.44±4.56 years. Ninety–two percent reported
treatment of overactive bladder (OAB) in children. Some children have a that they were not offered guidance on how/when to disclose; 49% thought
suboptimal response or suffer from side effects, dictating the necessity for they would benefit from support on this. There was a significant difference
other drugs to gain approbation. Our objectives were to assess and compare in nervousness to disclose if the condition was distal vs. proximal (p=0.008),
the efficacy and safety of fesoterodine and oxybutynin XL in the treatment with proximal being more nervous.
of children with OAB. Conclusions: To our knowledge, this is the first study to evaluate percep-
Methods: We performed a randomized, double–blind trial with a crossover tions and attitudes around disclosure in patients with hypospadias and
design in 64 children with OAB aged 5–14 years. Every child received a their families. The majority of respondents were planning to disclose the
daily dose of one of the two study drugs (feso 4 mg or oxy XL 10 mg) for operation to their child and were not offered any guidance or support as
an eight–week period. After a washout of three days, they did a second to the optimal way to disclose. Half of those parents thought they could
eight–week period with the other agent. Followup visits were scheduled benefit from resources to help them with this process. Further research is
(Weeks 0, 2, 10, 19). A three–day voiding diary was filled out before each required to understand the impact of disclosure and to create tools to help
visit. The efficacy and safety of the drugs were assessed through changes caregivers with this responsibility.
on the voiding diaries, the Patient Perception of Bladder Condition (PPBC)
score, side effects, vital signs, urinalysis, post–void residual, electrocardiog- POD–2.3
raphy (ECG), and blood tests. At the end of the study, children were asked Does breastfeeding reduce the risk of urinary tract infection in
to choose witch drug they preferred. If they chose fesoterodine (n=24), they infants with prenatal hydronephrosis?
were offered a one–year extension. At each visit, the safety and efficacy Melissa McGrath , Forough Farrokhyar , Smruthi Ramesh , Armando
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were evaluated, as previously described. Lorenzo , Luis Braga 1,2
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Results: Patients were either in Group 1 or 2 (feso–oxy or oxy–feso). Both 1 Department of Surgery, McMaster University, Hamilton, ON, Canada;
groups were similar. All had improvement of the parameters evaluated at 2 McMaster Pediatric Surgery Research Collaborative, McMaster University,
four months. We could not demonstrate a significant difference between Hamilton, ON, Canada; Department of Urology, The Hospital for Sick
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the two drugs. The differences between the PPBC score of the two drugs Children, Toronto, ON, Canada
was of 0.27, mean voided volume was of 8.6 ml, and no difference in Introduction: The role of breastfeeding (BF) in preventing urinary tract
daily frequency was noted. All noted side effects were mild and there were infections (UTIs) in infants with prenatal hydronephrosis (PHN) has, to our
no major adverse events. There seemed to be a few more adverse events knowledge, not been investigated.
with oxybutynin, with an odds ratio of 0.53 (95% confidence interval Methods: From 2009–2017, we prospectively screened 1198 patients with
0.26–1.1; p=0.09). HN. Patients ≤12 months old at presentation and diagnosed with grades I–IV
Conclusions: Fesoterodine or oxybutynin XL appeared to be effective and Society of Fetal Urology (SFU) HN were included (770). Medical records
safe treatment options for OAB in children. According to our current data, lacking BF information (390), anomalies (78), and those >12 months(289) at
the efficacy and safety of both molecules seems similar. baseline were excluded, resulting in 302 included infants. Baseline patient
demographics, BF history (age BF stopped, % BF), febrile (f)UTI rates, SFU
POD–2.2 grades, continuous antibiotic prophylaxis (CAP) status, and gender and
Parental perceptions and attitudes towards disclosure of circumcision status were captured. The primary outcome was UTI rate.
hypospadias repair Univariate and multivariate analyses of predetermined UTI risk factors
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Udi Blankstein , Melissa McGrath , Nathan Wong , Luis Braga 1,2 were done.
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1 Department of Surgery, McMaster University, Hamilton, ON, Canada; Results: Of 302 infants, 241 (80%) were male, 153 (63%) were uncircum-
2 McMaster Pediatric Surgery Research Collaborative, McMaster University, cised, and 139 (46%) had high–grade (III–IV) SFU HN. Overall, 34 (11%)
Hamilton, ON, Canada developed UTI. Thirty–five (11%) babies received formula only, 135 (45%)
Introduction: Boys with hypospadias often undergo reconstructive surgery had breast milk and formula, and 132 (44%) were breastfed exclusively. Of
to improve cosmetic appearance and functional outcomes. While the ethics BF patients, 198(74%) were breastfed for ≥6 months. BF had no effect on
of physician–patient disclosure of illness are clear, parent–child disclosure the rate of fUTI in this population, regardless of the intensity or duration.
is more ambiguous. There is a paucity of research regarding the parental Not being prescribed CAP (16% vs.7%; p=0.03) and having either primary
disclosure of past urological procedures, specifically hypospadias repair. non–refluxing megaureter or vesicoureteral reflux (VUR) as opposed to
Our objective was to determine the rate of parental disclosure in boys ureteropelvic junction obstruction (UPJO)–like (28%, 17% vs. 6%; p≤0.01)
undergoing hypospadias repair and to evaluate the parental perspectives were found to be associated with risk of developing a UTI (Table 1; avail-
regarding concerns and amount of support in relation. able at https://cua.guide/). On multivariate analysis, all three were again the
Methods: A web–based questionnaire was distributed to parents of hypospa- driving factors for UTI (Table 2; available at https://cua.guide/).
dias patients at McMaster Children’s Hospital pediatric urology outpatient Conclusions: Although there has been indication in the literature that BF
may provide some protection for infants against developing infections, in
S54 CUAJ • June 2018 • Volume 12(6Suppl2)
© 2018 Canadian Urological Association