AB022. SOH24AB_139. A 10-year review of general paediatric urology cases performed in a non-specialist centre in Ireland

Background: The Urology Model of Care recommends “satellite centres for managing general paediatric urology conditions in model 4 centres outside of Dublin” should be utilised for service provision. It states that that all new urology posts should have components of paediatric urology in the job description. However, most trainees will not rotate through a specialist paediatric urology unit. We reviewed the paediatric urology operative cases in a model 4 hospital.

Methods: Procedures performed in children aged <16 years between 2012–2022 at University Hospital Waterford were identified using local surgical databases, and only urology patients were isolated. Medical charts, electronic outpatient records and operation databases were accessed to collect data concerning demographics, emergency/elective presentation, operation performed, length of stay, complications and follow-up.

Results: A total of 441 paediatric urology operations (357 circumcisions, 45 orchidopexies, 16 orchidectomies, 14 hydrocoele repairs and 9 “other” scrotal explorations) were performed on children between the ages of 2–15 years old. Of the 45 orchidopexies performed, 13 were elective inguinal orchidopexy [10 undescended testes (UDT), 2 retractile testes, 1 trauma] and 32 were emergency scrotal orchidopexy (11 torsion, 14 pain, 4 appendage torsion, 3 trauma). Of circumcisions, 18 were performed as emergencies and 339 were elective. Median length of stay for orchidopexy and circumcisions was 1 day. Median follow-up for orchiopexy was 3 months.

Conclusions: Due to demand, the use of model 4 hospitals outside of Dublin for general paediatric urology cases will likely continue. In experienced hands, these cases can be performed safely. Prospective studies are needed to assess long-term outcomes particularly regarding inguinal orchidopexy for UDT.

Keywords: Ireland; model 4; non-specialist; paediatric; urology