JCU - Abstracts of the BAUS 2018 Scientific Meeting - June 2018 - 49

Abstracts
Introduction: Urethral diverticula (UD) are rare and
benign condition in female; misdiagnosis or delayed diagnosis is common. Here, we are highlighting the surgical
outcome of UD repair by using three layer closures with
judicious use of Martius flap interposition.
Material and Methods: Retrospective cohort studies of
patients who have had UD repair were analysed with
focus of imaging characteristics, intraoperative findings
and surgical outcome.
Results: A total of 26 patients with mean age of 43 years
underwent surgery including 4 patients (15.4%) had previous failed procedure in the period between Jan 2010 to
March 2017. A few patients present with classic triad
symptoms and most common videourodynamic findings
was the bladder outlet obstruction. MRI reported complex UD, simple UD and others in 11 (42%), 10 (38.5%)
and 5 (20%) patients respectively; UD located in the mid
urethra, proximal urethra and near to the bladder neck
reported in 12 (46.2%), 9 (34.6%) and 5 (19.2%) patients
respectively. Only three layers closure performed in 21
(80.8%) patients and 5 (19.2%) patients received additional
Martius flap interposition because UD located near to the
bladder neck or previous failed procedure. There was no
recurrence in patients those had Martius flap interposition
and only 1 (4.8%) recurrence out of 21 patients among
those repaired by only three layers closure.
Conclusion: Excellent outcomes are achievable with
using three layer closure techniques without routine use
of Martius flap interposition which in our opinion should
be used in a limited number of patients with recurrent and
very complex diverticulum.
P5-3 Percutaneous tibial nerve stimulation in
overactive bladder - A prospective study
Moghul M1, Green L1, Dadswell R1, McDonald J1
1North Middlesex Hospital, London, United Kingdom

Introduction: Percutaneous tibial nerve stimulation
(PTNS) has been used to treat patients complaining of
lower urinary tracts symptoms, including overactive bladder (OAB) which affects around 15% of the population.
We have performed a prospective study looking at the use
of PTNS for OAB at our institution.
Methods: Between 2015 and 2017 we included all men
and women that had 6 sessions of PTNS at our institution.
We excluded those that did not complete either an ICIQ
(International Consultation on Incontinence Questionnaire)
or IIQ-7 (Incontinence Impact Questionnaire) both pre
and post treatment.We used a paired t-test to see whether
the difference in scores was significant.
Results: 106 women and 44 men and were treated with 6
sessions of PTNS for OAB at our institution and completed pre and post PTNS questionnaires. For women the
average ICIQ score pre-PTNS was 9.46 (SD±2.75) and

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post-PTNS was 7.69 (SD±3.14). This was a significant
decrease (P<0.001). The average IIQ-7 score for women
pre-PTNS was 57.2 (SD±27.3) and post-PTNS was 48.2
(SD±29.0), this was also a significant decrease (P<0.003).
For men the average ICIQ score pre-PTNS was 9.28
(SD±2.99) and post-PTNS was 7.58 (SD±2.99). This was a
significant decrease (P<0.001). The average IIQ-7 score for
men pre-PTNS was 51.6 (SD±31.7) and post-PTNS was
39.2 (SD±30.8), this was also a significant decrease (P<0.01).
Conclusions: In our experience PTNS seems to result in
significantly lower ICIQ and IIQ-7 scores indicating
improved symptoms in our patients.
P5-4 The clinical and cost effectiveness of
acupuncture for symptomatic idiopathic
detrusor overactivity
Jenks J1, Paras J1, Itam S1, Pakzad M1, Ockrim J1, Hamid
R1, Greenwell T1
1University College Hospital at Westmoreland Street, London, United
Kingdom

Introduction: Symptomatic idiopathic detrusor overactivity (IDO) is extremely common. Adherence to pharmacotherapy is poor, and surgical interventions are costly
and invasive. We have assessed the clinical effectiveness
and cost effectiveness of acupuncture in the treatment of
symptomatic IDO.
Patients and Methods: 30 patients having acupuncture
for symptomatic IDO were prospectively evaluated using
objective (frequency/volume chart) and subjective (EQ5D,
ICIQ-OAB, pain scores) measures. Outcome measures
were assessed at baseline and post treatment and compared for responders and non-responders.
A cost analysis was performed comparing acupuncture
with mono and duel drug pharmacotherapies commonly
used in OAB and conservative management methods (pelvic floor muscle exercises and bladder retraining). A cost
comparison was made between all treatment options at
both six weeks and six months.
Results: Patients' OAB symptoms completely resolved in
14.8%, significantly improved in 59.3% and remained
unchanged in 25.9% following a 6 week course of acupuncture treatment. Responders had a significantly lower
mean pre-treatment functional capacity compared with
non-responders and had a significant increase in this functional capacity following treatment. No adverse events
were recorded. Acupuncture carried a significantly higher
cost burden at six weeks, six months and overall (£2090)
compared to pharmacotherapy (£506) and conservative
methods (£724).
Conclusion: Acupuncture is a well-tolerated and effective treatment with no incidence of side effects and should
be part of a Urology specialist's armamentarium in a comprehensive continence service. It is significantly more

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