Page 78 - Poster Sessions] CUA 2022 Annual Meeting Abstracts

2022 CUA Abstracts

MP-10.5 Conclusions: While many individuals diagnosed with EEC experience
The diagnosis and management of acute epididymitis in children QoL that is equal to that of the general population, experiences with
not related to sexually transmitted infection in children: A incontinence, concerns about the appearance of genitalia, and anxiety
retrospective review surrounding the condition do affect MH, psychosocial functioning, and
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Yuding Wang , Zoe Baker , Hannah Dillon , Joan Ko 1 HRQoL in individuals across the life course.
1 Division of Urology, Department of Surgery, Children’s Hospital of Los
Angeles, Los Angeles, CA, United States MP-10.7
Introduction: Epididymitis remains a common cause of acute testicular Pediatric urolithiasis in Ontario, Canada: A retrospective review
pain in children. Except for epididymitis caused by sexually transmit- of surgical trends and management
ted infections (STIs), management strategies remain inconsistent, with Fernanda Gabrigna Berto , Andrew McClure , Zhan Tao Wang , Jennifer
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no clear guidelines. Herein, we sought to understand treatment patterns Bjazevic , Dor Golomb , Guido Filler , Blayne Welk , Hassan Razvi , Sumit
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and related outcomes of children with non-STI-associated epididymitis Dave 1
seen by an academic pediatric urology practice. 1 Department of Surgery, Western University, London, ON, Canada;
Methods: A single-center, retrospective review was completed among all 2 Department of Epidemiology and Biostatistics, Western University,
patients referred to a pediatric urology group with presumed diagnosis London, ON, Canada; Assuta Ashdod, Ashdod, Israel; Department of
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of non-STI-associated epididymitis/-orchitis from 2015–2020. Data on Pediatrics, Western University, London, ON, Canada
referring emergency department (ED) or family physician workup were Introduction: Pediatric urolithiasis (PUL) is a recurrent condition with a
reviewed. Logistic regression analyses and Pearson Chi-squared tests were growing incidence worldwide that results in significant patient morbid-
used to assess associations between patient presentation, prescription of ity and healthcare expenditure. This study evaluated surgical trends and
antibiotics (Abx), and epididymitis recurrence. management of PUL in the province of Ontario, Canada from 2002–2018.
Results: A total of 127 patients with epididymitis were included; 70.1% Methods: This retrospective cohort administrative database study identi-
were referred from a dedicated pediatric ED. Among all patients, 56.7% fied all children (<18 years) who underwent their first surgical treatment
had a urinalysis (UA) as part of the initial workup, while 48.8% were for PUL identified using the Canadian Institute for Health Information-
prescribed Abx. Patients not referred from a dedicated pediatric ED were Discharge Abstract Database or an Ontario Health Insurance Plan billing.
2.7 times more likely to receive Abx for management of epididymitis (95% Linked databases held at the Institute of Clinical Evaluative Sciences (ICES)
confidence interval [CI] 1.2–5.9, p=0.01). Having a UA was not signifi- were used to identify variables and outcomes. Descriptive statistics were
cantly associated with Abx, while having a positive UA was associated used to analyze demographics and surgical trends, and logistic regression
with Abx treatment (odds ratio 3.6, 95% CI 1.2–6.0, p=0.01) irrespective to identify risk factors for repeat surgical intervention.
of culture results. Twelve patients had recurrent epididymitis, which was Results: A total of 1149 patients underwent a first surgical procedure for
not associated with receipt of Abx (p=0.49). PUL (mean age 11.27±5.7 years). The number of surgical procedures per-
Conclusions: While practice patterns vary, Abx are widely prescribed formed annually (p=0.059) and PUL surgery incidence rates were relatively
to children diagnosed with non-STI-associated epididymitis based on stable (p=0.08). There was a trend towards increased use of ureteroscopy
UA results, which has unknown utility for epididymitis diagnosis and (URS) compared to shockwave lithotripsy (SWL) (p=0.145), while percuta-
management. Prospective data are needed to identify clear guidelines neous nephrolithotomy remained stable. Outcomes were reviewed for
for managing pediatric epididymitis. 706 patients who had an index procedure from 2002–2016 and available
followup for at least twoyears; 17.71% had a repeat procedure within six
MP-10.6 months, predominantly with URS. Renal stone location (odds ratio [OR]
Mental health, psychosocial functioning, and health-related 2.79, p=0.0002) and SWL (OR 1.66, p=0.0025) were independent risk
quality of life of children, adolescents, and adults with bladder factors for repeat surgical procedure within six months. Stone recurrence
exstrophy, cloacal exstrophy, and epispadias: A scoping review requiring surgical intervention was 20.4% within five years.
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Michelle SooHoo , Zoe Baker , Yuding Wang , Hannah Dillon , Arthi Conclusions: The overall rate of surgically treated PUL was stable in
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Hannallah , Lynn Kysh , Zorash Montano , Evalynn Vasquez 1 Ontario, Canada from 2002–2018. URS was the most common surgical
1 Division of Urology, Department of Surgery, Children’s Hospital of Los treatment modality, and a decline in SWL rates was observed reflecting
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Angeles, Los Angeles, CA, United States; Department of Psychology, similar trends noted in adults. PUL was associated with a high surgical
Phoenix Children’s Hospital, Phoenix, AZ, United States re-intervention rate within six months.
Introduction: The exstrophy-epispadias complex (EEC) is a collection of
rare congenital conditions affecting the urinary system. Currently, there MP-10.8
is not a clear consensus on the psychosocial functioning, mental health Primary ablation vs. urinary diversion in posterior urethral valve:
(MH) status, or health-related quality of life (HRQoL) of individuals with A meta-analysis
EEC. The aim of this scoping review was to synthesize the existing litera- Adree Khondker , Justin Chan , Jin Kyu (Justin) Kim , Michael Chua ,
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ture related to the MH status, psychosocial functioning, and HRQoL of Brittney Henderson , Priyank Yadav , Joana Dos Santos , Gregory Tasian ,
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individuals with EEC across the life course. Mandy Rickard , Armando Lorenzo 1
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Methods: Databases, including PubMed, Embase, Cochrane Library, 1 Division of Urology, The Hospital for Sick Children, Toronto, ON, Canada;
CINAHL, Web of Science, PsycINFO, ERIC, and Google Scholar, were 2 Division of Urology, Children’s Hospital of Philadelphia, Philadelphia,
searched from inception using preidentified key terms. Two independent PA, United States
reviewers performed abstract screening of 5431 articles, followed by Introduction: The literature regarding the ideal initial surgical manage-
full-text review of 245 articles. All articles including primary analysis ment of posterior urethral valves (PUV) patients is conflicted. Here, we
on the psychosocial functioning, MH status, or QoL of individuals with aimed to determine long-term kidney and bladder outcomes in boys
EEC were included in the review, and recurring themes were identified. with PUV undergoing either primary valve ablation or urinary diversion.
Results: A total of 66 articles met inclusion criteria and were included Methods: A systematic search was performed in March 2021. Comparative
in this review. Findings suggest that MH status and QoL change across studies were evaluated according to Cochrane collaboration recommen-
the life course in individuals with EEC. Children with EEC demonstrate dations. Assessed measures included kidney outcomes (chronic kidney
more externalizing behaviors, while adolescents and adults with EEC disease stage, kidney function) and bladder outcomes, among others.
demonstrate higher levels of internalizing behaviors and psychological Odds ratios (OR) and mean difference with 95% confidence interval (CI)
distress, particularly anxiety. Additionally, children appear to demon- were extrapolated from available data. Random-effects meta-analyses
strate improved QoL after surgery to improve continence; however, while were performed and confounders were assessed with subgroup analysis.
overall QoL is comparable to the general population, adolescents and The review was registered prospectively (PROSPERO CRD42021243967).
adults experience lower QoL in the areas of self-care and general health.
S100 CUAJ • June 2022 • Volume 16, Issue 6(Suppl1)