JCU - Abstracts of the BAUS 2018 Scientific Meeting - June 2018 - 48

48
Results: 130 unilateral and 22 bilateral procedures were
performed with 99% overall success rate. The majority
were requested by urologists (76%) and oncologists (16%).
Malignancy (47%) and stone disease (35%) and were the
commonest indications. Follow up data was available for
144 successful procedures in 139 patients. Overall, 31
patients (22%) died. 29 of 63 patients (46%) with malignancy died after a median interval of 3.4 months (range
6-688 days). Thirteen (15%) waited over 6 months for
stent removal and five (26%) waited over 12 months for
stent exchange. Nine patients (6.5%) had forgotten stents,
having been in situ for over six months with no intervention planned. Of these, four were inserted for gynaecological malignancy and three for benign disease.
Conclusions: This study provides prognostic information
for patients stented for malignant obstruction and highlights hazards of inadequate follow up, causing delays in
stent removal and exchange, or the forgotten stent.
Interventions are described to minimise these risks.
P4-16 Non-operative management of pelviureteric obstruction (PUJO)
Hanah M1, Mann 1
University Hospitals, United Kingdom, 2Rotherham
General Hospital, United Kingdom
1Nottingham

PUJO may be discovered due to symptoms or as an incidental finding and often in the older patient. The classical
treatment for adults with renographically proven PUJO is
pyeloplasty with high success rates but conservative management may be considered. The indications for conservative management are not clear and guidance is variable.
We reviewed the outcomes for patients managed without
surgery with PUJO.
Forty-eight patients undergoing non-operative management
(mean age 60y) with renographically proven PUJO were
reviewed. Renographic follow up was for a mean of 1.8 years.
There were a variety of reasons for conservative management including patient preference and lack of symptoms.
Patients were kept under clinical and radiological review.
Surgery was offered if patients became symptomatic or if
there was loss of function as determined renographically.
The mean relative renal function of the affected side was
44% at diagnosis and was measured at 43% after a mean
follow up of 22 months. Of the 48 patients five (10.4%)
eventually underwent pyeloplasty. Of the remaining
patients who were considered fit for surgery and remained
asymptomatic there was no loss of relative renal function
nor any need for intervention.
With careful selection, PUJO can be managed conservatively with no adverse outcomes for these patients. A
small fraction of patients showed renographic deterioration during surveillance and underwent surgical correction with no disadvantage.

Journal of Clinical Urology 11(1S)

ePoster Session 5:
Female, Neurological and
Urodynamic Urology 1
Tuesday 26 June
10:30 - 12:00
Room 12
Chairs: Angela Birnie & Ased Ali
P5-1 Paraurethral cysts in adult women
- symptoms, urodynamic findings and
outcomes of complete excision
O'Connor E1, Kocadeg H1, Pakzad M1, Hamid R1,
Ockrim J1, Greenwell T1
1University College Hospital at Westmoreland Street, United
Kingdom

Introduction: To review and describe the presenting
symptoms, urodynamic findings and outcomes of complete excision of paraurethral cysts.
Patients and Methods: We retrospectively reviewed a
prospectively collected database of 16 consecutive women
of median age 35 years [range 17-54] having excision of
paraurethral cyst between 2011 and 2017 for presenting
symptoms, pre-operative urodynamic findings, surgical
management and outcomes.
Results: 15 (93.8%) women presented with a palpable vaginal lump. Other complaints included dyspareunia, vaginal
discharge and voiding difficulty. 10 (62.5%) were referred
with a clinical and MRI diagnosis of urethral diverticulum. 8
(50%) had urodynamic evidence of BOO consequent to
their cyst, whilst 3 (18.8%) had evidence of idiopathic detrusor overactivity (2 in association with BOO). All cysts were
solitary and measured from 1.1 to 4.5cm in maximum
dimension. 10 (62.5%) patients had cyst excision, 5 (31.3%)
had cyst excision, repair of underlying adherent distal urethra and interposition of paraurethral tissue whilst 1 (6.3%)
had cyst excision, repair of adherent mid and distal urethra
and interposition of a modified Martius labial fat pad flap.
The median follow-up period was 6 months (2.5-35). No
complications or recurrences were demonstrated and presenting symptoms resolved in 15 (93.8%).
Conclusion: Paraurethral cysts are often mistaken both
clinically and on MRI for urethral diverticulum. They cause
similar symptoms and are associated with urodynamic
abnormalities in > 50%. Complete excision resolves symptoms in 93.8% but may require urethral repair and tissue
interposition in 37.6%.
P5-2 Is routine Martius flap interposition
required in female urethral diverticula repair?
Rizvi I1, Suliman A1, Almallah Z1, Belal M1
1Queen Elizabeth Hospital, Birmingham, United Kingdom

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