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S23: AUGMENTATION / DIVERSION
Moderators: Mark Cain (USA), Antonio Macedo (Brazil)
ESPU Meeting on Saturday 17, October 2015, 10:09 - 10:39
10:09 - 10:12
S23-1
(PP)
★
PATIENTS WHO BECOME OBESE FOLLOWING CONTINENT CATHETERIZABLE
URINARY CHANNEL PLACEMENT ARE NOT AT INCREASED RISK FOR SUBFASCIAL
REVISION
Katherine HUBERT
1
, Konrad SZYMANSKI
1
, Xiaochun LI
2
, Susan OFNER
2
, Chandra FLACK
1
, Benjamin JUDGE
1
, Benjamin
WHITTAM
1
, Rosalia MISSERI
1
, Martin KAEFER
1
, Richard RINK
1
and Mark CAIN
1
1) Riley Hospital for Children at Indiana University Health, Urology, Indianapolis, USA - 2) Indiana University School of
Medicine, Biostatistics, Indianapolis, USA
PURPOSE
We previously reported that Monti catheterizable channels were two times more likely than appendicovesicostomy (APV)
to undergo revision and that spiral Monti to the umbilicus was four times more likely than APV to undergo revision. The
purpose of this study was to evaluate whether the development of obesity postoperatively was a risk factor for
subfascial revision in patients undergoing continent catheterizable channel (CCC) placement.
MATERIAL AND METHODS
We retrospectively reviewed an institutional database of patients born in or after 1972 who underwent CCC placement
between ages 2 and 21 years from January 1990-May 2013 excluding those with continent urinary reservoirs, continent
vesicostomies and those without body mass index (BMI) data available. We collected data on patient/procedure
characteristics, baseline and most recent BMI, subfascial revisions, and follow-up duration. We used Fisher’s exact test
to compare rates of subfascial revision between those who became overweight/obese (BMI greater than or equal to 25)
versus those who had stable low/normal BMI, stable overweight/obese BMI and those with overweight/obese BMI who
became low/normal.
RESULTS
332/507 (65.5%) patients had baseline and post-baseline BMI data (53.0% male, 90.4% white, median age 7.4 years,
41.0% appendicovesicostomy, 59.0% Monti). Median follow-up was 76.4 months. 59.6% had spina bifida. 38/332
(11.4%) had subfascial revisions. 53/332 (16%) developed obesity postoperatively. 7.6% of those who developed
obesity had a subfascial revision vs.12.2% of those whose weight remained stable or decreased (p=0.48).
CONCLUSIONS
This study suggests that development of postoperative obesity is not a risk factor for subfascial revision.