Page 100 - CUA Absracts 2022_Fulldraft

2022 CUA ABSTRACTS

CUA 2022 Annual Meeting Abstracts – Poster Session 10: Pediatrics

Sunday, June 26, 2022 • 07:30–09:00

Cite as: Can Urol Assoc J 2022;16(6Suppl1):S98-104. http://dx.doi.org/10.5489/cuaj.7932

MP-10.1
First North American experience of propiverine use in children
with overactive bladder
1
1
1
Élisabeth Lapointe , Narcisse Singbo , Elizabeth Naud , Stephane Bolduc 1
1 Division of Urology, Department of Surgery, CHU de Québec - Université
Laval Research Centre, Quebec, QC, Canada
Introduction: Antimuscarinics are the cornerstone of the pharmacological
treatment of overactive bladder (OAB) but side effects often limit their long-
term use. Propiverine hydrochloride, a molecule with a mixed mechanism
of action, was approved in Canada in 2017 as a therapy for OAB in adults
and children. However, there is scarce data on its efficacy and tolerability
in the pediatric population. Our primary objective was to assess the efficacy
and tolerability of propiverine as a first- or second-line pharmacological
treatment of OAB in children. Our secondary objective was to compare
propiverine to other molecules already investigated in historical cohorts.
Methods: We conducted a retrospective analysis of a prospectively main-
tained database and reviewed 58 patients who received propiverine
between 2017 and 2021. Patients had to attend at least one followup visit
to be included. Efficacy and tolerability were assessed through voiding
diaries, postvoid residuals (PVR), and by questioning patients and families
on change in the number of incontinence episodes (day and night), in MP-10.3. Figure 1. Number of testis and ovarian biopsies since 2011.
urgency episodes (grade 1–3), and on reported adverse events. Categorical
variables were reported as counts and percentages, and descriptive statistics
(mean and standard deviation or medians and quartiles) were reported for cryopreservation of sperm or oocytes. In prepubertal individuals, immature
continuous variables. Paired tests were used to assess the evolution of mean ovarian and testicular tissue can be frozen; however, this is considered
bladder capacity and expected bladder capacity (%EBC) scores at different largely experimental. Our objective was to quantify who is receiving FP
followup points, and linear regression models with the GEE method were procedures in young adults with cancer.
used to estimate their average monthly variation. Methods: We performed a retrospective study of children under 18 years
Results: Fifty-eight patients (37 boys) initiated treatment at a mean age of old who had surgery in 52 U.S. pediatric hospitals registered in the Pediatric
9.5±3.2 years. Patients were on propiverine for an average of 15.9±12.4 Health Information System (PHIS) from 2011–2019. Male and female can-
months. Mean bladder capacity increased from 120 ml to 216 ml, and cer patients who underwent a testicular or ovarian biopsy were included.
%EBC increased from 37% to 59%. The average increased rate of %EBC Any patients with testicular or ovarian malignancy, torsion, or other diag-
was 0.5% per month (p<0.001). Of the 58 patients, eight were able to stop noses that may have required a gonadal biopsy were excluded.
the medication completely without symptom recurrence, 21 are still on Results: A total of 600 boys and 550 girls who underwent a gonadal biopsy
medication, and six are on dose-tapering. Due to treatment-related adverse were identified. After applying the exclusion criteria, 418 boys and 333
events, seven interrupted their treatment. Compared to other molecules girls, with a mean age at gonadal biopsy of 8.3 (boys) and 8.8 (girls) years,
regularly used in our service, propiverine offered comparable efficacy and were included in the analysis; 363 boys were 12 and under and 55 boys
tolerability. Our study had limitations: the absence of a placebo group and were above 12, while 224 girls were 11 and under and 109 were above
its retrospective design. 11. The most common cancer diagnosis was hematological in both boys
Conclusions: Propiverine appears to be an efficient and safe option for (50.96%) and girls (36.64%). A concurrent procedure at time of testis
treating OAB in children and is approved for use in children. biopsy was performed in 84% of boys, with chemotherapy device inser-
tion being the most common (54.87%). In girls, a concurrent procedure
took place 62% of the time, with chemotherapy device insertion being
MP-10.3 the most common at 40% (Tables 1, 2, 3). When separating patients into
Incidence of fertility preservation procedures in prepubertal and pre- and post-pubertal, no differences in characteristics were seen in boys
pubertal individuals with cancer or girls. Overall, the total number of testis and ovarian biopsies has been
3
1
2
Landan MacDonald , Daniel E. Nassau , Carlos Delgado-Rodriguez , Aditya increasing since 2011 (Figure 1).
4
2
Sathe , Sirpi Nackeeran , Pranay Manda , Akshay Reddy , Rodrigo Romao , Conclusions: Since 2011, gonadal biopsy rates have increased in adoles-
5
4
1
Ranjith Ramasamy , Jesse Ory 1,2 cents and children with cancer, presumably for FP. Our findings highlight
2
1 Department of Urology, Dalhousie University, Halifax, NS, Canada; the need to establish protocols and tracking for FP procedures in the U.S.
2 Department of Urology, University of Miami, Miami, FL, United States;
3 Department of Urology, Tecnologico de Monterrey, Monterrey, Mexico;
4 Faculty of Medicine, University of Tennessee Health Sciences Center,
Memphis, TN, United States; Faculty of Medicine, University of Michigan,
5
Ann Arbor, MI, United States
Introduction: Fertility preservation (FP) for children and adolescents with
cancer is underused. In postpubertal boys and girls, FP is achieved by
S98 CUAJ • June 2022 • Volume 16, Issue 6(Suppl1)
© 2022 Canadian Urological Association