MP53-09: Characteristics Of Leakage from Catheterizable Channels. Can The Underlying Ethiology Determine the Onset of The Symptom And Predict Management?
Introduction: (Double) Monti and Mitrofanoff procedures, are the current standart for continent catheterizable channels in our daily practice. We specifically examined the post operative onset time, underlying reason and management of stomal incontinence. Methods: Patients that underwent aforementioned procedures and were compliant on follow-ups, between Jan-2000 and Dec-2022 (n = 143), were included in the study. All patients had been followed at 1st, 3rd, 6th months and then annually. Depending on the onset time of stomal incontinence, patients were categorized into 3 groups (very-early-leak: 0-6 months, early-leak: 6-24 months, late-leak: 24 months). Results: 13% of the patients (N = 19) had very-early-leak. All of them are initially followed with anticholinergics. 89% of them (N = 17) were continent after 2 months without drugs. Remaining 2 patients were continent after bulking agent injection. 6.2% of the patients had an early-leak (N = 9. They were treated initially with anticholinergic medication. The medical treatment was successful only for 11% of patients (N = 1). Other 8 patients were treated with injection resulting in total continence for 7 of them. Injection was not successful for 1 patient at first month of follow-up, who later underwent a surgical correction (N = 1). Late-leak was seen in 3% of patients (N = 4). Among those, 1 of them was non-compliant with the CIC schedule, and subsequently had no complaints after compliance. Other 3 patients were leak-free with chronic usage of anticholinergic medications. The success rates of treatment modalities were significantly different in 3 groups. (p < 0.05) Conclusions: Very-early-leak is mainly caused by the ongoing adaptation of the augmented bladder and likely to resolve spontaneously. Early-leak does not initially respond to anticholinergic medication and more likely to indicate an endoscopic intervention. Late-leak is caused by non-compliance to CIC or later diminished bladder capacity, both of which can be treated without any surgical intervention. SOURCE OF Funding: Ankara University
