Decisional regret is low after both continent and incontinent urinary tract reconstruction in patients with neurogenic bladder

You have accessJournal of UrologyCME1 Apr 2023MP53-10 DECISIONAL REGRET IS LOW AFTER BOTH CONTINENT AND INCONTINENT URINARY TRACT RECONSTRUCTION IN PATIENTS WITH NEUROGENIC BLADDER Kristin Ebert, Anja Zann, Seth Alpert, Christina Ching, Daniel Dajusta, Rama Jayanthi, Daryl McLeod, and Molly Fuchs Kristin EbertKristin Ebert More articles by this author , Anja ZannAnja Zann More articles by this author , Seth AlpertSeth Alpert More articles by this author , Christina ChingChristina Ching More articles by this author , Daniel DajustaDaniel Dajusta More articles by this author , Rama JayanthiRama Jayanthi More articles by this author , Daryl McLeodDaryl McLeod More articles by this author , and Molly FuchsMolly Fuchs More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003301.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Continent or incontinent urinary tract reconstruction may be needed in pediatric patients with neurogenic bladder (NGB) to achieve continence per urethra. Choosing a reconstructive technique involves shared decision-making. We aimed to compare decisional regret (DR) and quality of life (QOL) in NGB patients who underwent continent vs. incontinent reconstruction, hypothesizing there would be no difference in DR and QOL between groups. METHODS: This was a single-institution retrospective cohort study. We included NGB patients who underwent urinary tract reconstruction from 2010-2020. The continent group included those who underwent bladder augmentation or neobladder, and the incontinent group was those who underwent a chimney or conduit procedure. We excluded patients <4 years of age, with severe developmental delay, or unable to speak English, and those with follow-up <1 year. The patient/legal guardian completed a demographic questionnaire and validated Decisional Regret Scale (DRS). The patient completed the QUALAS, a measure of QOL applicable to NGB. Other clinical information was collected via chart review. Our primary outcome was measured by DRS score, in categorical fashion (0-25=no/mild regret, >25=moderate/severe regret). Our secondary outcome was measured by the continuous score (max score 100) on the bladder/bowel domain (BBD) of the QUALAS. Chi square/Fisher exact test, t-tests, or Mann Whitney tests were used to assess differences between groups. RESULTS: 95 patients (70 continent) met inclusion criteria. Survey response rate was 67% (51 continent, 13 incontinent). Patients in the incontinent group were older at time of surgery. More patients in the continent group had a household income of ≥$50,000. There was a higher frequency of enema use for bowel management in the continent group. There were no differences between groups in frequency of patients with moderate/severe DR and in median BBD QUALAS score. CONCLUSIONS: We found no differences in DR and QOL in patients who underwent continent vs. incontinent reconstruction. Patients who are older at time of continence readiness, from families with lower household income, and unable to perform enemas may be more likely to benefit from incontinent reconstruction. Source of Funding: NURAG Grant Nationwide Children's Hospital © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e715 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kristin Ebert More articles by this author Anja Zann More articles by this author Seth Alpert More articles by this author Christina Ching More articles by this author Daniel Dajusta More articles by this author Rama Jayanthi More articles by this author Daryl McLeod More articles by this author Molly Fuchs More articles by this author Expand All Advertisement PDF downloadLoading ...