Page 12 - CUA 2020_Functional Urology

Unmoderated Posters 3: Prostate Cancer, Functional Urology, Other Urology Topics

UP-3.18 be performed for both diagnosis and appropriate management of LUTD
The association of neurofibromatosis type 1 and lower urinary in patients with NF1.
tract dysfunction in the pediatric population References
2
1
2
3
Bruce Gao , Keara Decotiis , Adam Bobrowski , Martin A. Koyle , Fardod 1. Tonsgard JH. Clinical manifestations and management of neurofi-
O’Kelly 2 bromatosis type 1. Semin Pediatr Neurol 2006;13:2-7. https://doi.
1 Urology, University of Toronto, Toronto, ON, Canada; Urology, The org/10.1016/j.spen.2006.01.005
2
Hospital for Sick Children, Toronto, ON, Canada; Undergraduate Medical 2. Kaefer M, Adams MC, Rink RC, et al. Principles in management of
3
Education, University of Toronto, Toronto, ON, Canada complex pediatric genitourinary plexiform neurofibroma. Urology
Introduction: Neurofibromatosis type 1 (NF1) is an autosomal-dominant, 1997;49:936-40. https://doi.org/10.1016/S0090-4295(97)00098-8
multisystem, neurocutaneous disorder. This condition has been associ- 3. Bouty A, Dobremez E, Harper L, et al, Bladder dysfunction in
1
ated with lower urinary tract dysfunction due to either direct genitouri- children with neurofibromatosis type I: Report of four cases and
2,3
nary organ involvement or spinal cord compression. Based on current review of the literature. Urol Int 2018;100:339-45. https://doi.
literature, there are no reviews examining the relationship between NF1 org/10.1159/000487193
and lower urinary tract dysfunction (LUTD) in the pediatric population.
Methods: A critical review of the literature was conducted using a system- UP-3.19
atic search of MEDLINE, PubMed, and Embase yielding a total of 1285 Use of smartphone camera and telemedicine in the management
manuscripts published up to 2019. Two independent reviewers selected of neonatal priapism
studies for screening, eligibility, and inclusion into the review (Fig. 1). O. Emmanuel Abara , Natasha Samarasinghe , Maurice Levy 3
1
2
Following title, abstract, and full-text review, 45 articles were analyzed. 1 Division of Clinical Sciences, Surgery (Urology), Northern Ontario School
Results: Within these 45 articles, 79 cases were presented (Fig. 2). The of Medicine/RHUPPI, Sudbury/Richmond Hill, ON, Canada; Community
2
mean patient age at the time of presentation was 6.97±9.19 years. The Pediatric Practice, Richmond Hill Pediatrics, Richmond Hill, ON,
most common urological presentations were irritative lower urinary tract Canada; Pediatrics, North York General Hospital/Bathurst Medical Centre,
3
symptoms (30%) and a newly discovered abdominopelvic mass (21%). Toronto/Thornhill, ON, Canada
Diagnostic investigations commonly demonstrated a retrovesical mass Introduction: Priapism in the neonate is rare, poorly understood, and
with direct invasion of the bladder in 58 cases (73%) and other geni- not commonly reported in the literature. Parents and primary healthcare
tourinary organ involvement in 39 cases (39%). Throughout the total providers are concerned and seek expert opinion. The use of smartphone
case volume, LUTD was present in 49%. Pathology of malignancy was camera and telemedicine on two cases seen between February 14, 2018
most commonly malignant peripheral nerve sheath tumor and rhabdo- and June 15, 2019 is presented.
myosarcoma (20% and 14%, respectively). When indicated, surgical Methods: Case 1: A five-day old baby was referred on February 14, 2018
management of the lower urinary tract included both radical and partial with a history of persistent intermittent penile erections since birth. A
cystectomy. Conservative management of urinary retention included clean term baby, the child had no pain and urinated normally. The parents
intermittent catheterization (56%), suprapubic catheterization (22%), vesi- were concerned whether this will affect their decision for the child to
costomy creation (11%), and Mitrofanoff creation (11%). be circumcised on the eight day of life, as done in their culture. The
Conclusions: A complete urological evaluation, including clinical, radio- mother documented episodes of prolonged erections with her smart
logical, and possibly pathological investigation, is warranted and should phone camera. Occurrence of priapism during the office visit matched
the digital photo appearance. Watchful waiting was adopted. He had a
successful circumcision on the eight day of life. Followup has included
telemedicine e-visits with no reported recurrence in 18 months. Case 2:
A 19-day-old baby was referred on October 30, 2018 with suspected
penile chordee. Parents, however, expressed concerns of baby having
prolonged intermittent penile erections since birth. The mother’s smart
phone images of prolonged penile erections were similar in appearance as
during the office visit. Watchful waiting with periodic assessment through
telemedicine was done. Priapism resolved before age 28 days, with no
recurrence in 12 months.
Results: Parents were concerned about the prolonged penile erections
and documented these episodes with their smart phone cameras. The
digital photos were helpful in assessment and treatment. The outcome of
watchful waiting management was satisfactory. This is in keeping with the
reported cases in the literature. Telemedicine as a platform for followup
1
was attractive to the mothers.
UP-3.18. Fig. 1. Study flowchart. Conclusions: Neonatal priapism causes anxiety for the parents. The use
of smart phone cameras by mothers to document neonatal priapism can
be useful in the watchful waiting management strategy. Telemedicine was
attractive, time saving and convenient.
Reference
1. Dust N, Dahoval T, Guerra L. Evaluation and management of pri-
apism in a newborn: A case report and review of the literature.
Paediatr Child Health 2011:16:e6-e8. https://doi.org/10.1093/
pch/16.1.e6

UP-3.18. Fig. 2. Publication trend.

CUAJ • June 2020 • Volume 14, Issue 6(Suppl2) S75