MP56-10 POST-OPERATIVE COMPLICATIONS OF SPINA BIFIDA PATIENTS UNDERGOING UROLOGICAL EXPLORATORY LAPAROTOMIES- A MULTI-INSTITUTIONAL ANALYSIS

Ascending cystourethrogram (ACU) with micturating cystourethrogram (MCU), pelvic and abdominal ultrasound, serum creatinine and urine analysis and culture were performed for all patients. Statistical differences between groups were tested using Chisquare, Nonparametric Mann Whitney test and Friedman test. A p-value less than 0.05 was considered statistically significant. RESULTS: 23 (72%) patients underwent bladder neck reconstruction (BNI), 19 (59%) underwent augmentation ileocystoplasty (AI), 5 (16%) underwent ureterovesical implantation (UVI), 22 (69%) of the patients underwent osteotomy, 9 (28%) patients were totally or partially continent, 3 patients (9%)underwentMitrofanoff, 8 (25%)patientshadapenopubicfistula. 18 patients (56%) had urinary tract infection, 24 (75%) patients showed no backpressure changes, 3 (9%) patients showed unilateral backpressure changes, 5 (16%) patients showed bilateral backpressure changes. ACU andMCU results showed 8 (25%) patients had no refluxing ureters, 15 (47%) patients showed unilateral reflux and 9 (28%) patients showed bilateral reflux. Mean serum creatinine level 0.71 0.22 mg/dl. Presence of hydronephrosis was statistically significant correlated with less number of operations 0.02 p value. Patients who did not perform AI showed statistically significance higher incidence of refluxing ureters p-value 1⁄4 0.01. Mitrofanoff procedure showed statistically significant better results regarding continence p-value 1⁄4 0.001. Age at first intervention, number of operations, AI, BNR did not show any statistically correlation with serum creatinine level or infection. CONCLUSIONS: Upper urinary tract follow up is of utmost importance, augmentation ileocystoplasty and Mitrofanoff urinary diversion can be a quiet combined savior procedure for the upper urinary tract and an acceptable continence results.