The ejaculatory duct ectopically invading the bladder with multiple congenital malformations of the homolateral urogenital system： a report of a rare case and an embryological review

We report a rare case of a left ejaculatory duct that allotropically protrudes towards or invades the left vesicle triangular area with its dead end. The patient simultaneously exhibited multiple congenital malformations of the homolateral urogenital system, such as absence of the left kidney, dysplasia and allotopia of the left seminal vesicle, absence of the left ureterostoma, separation between the left testis and the epididymis tail, and maldevelopment of the left testis. According to all clinical and laboratory evidence, the case represented a new syndrome, which we named Wuyang＇s syndrome. It involved a rare phenomenon in embryonic development; the dysplastic proximal vas precursor, having intruded into a common mesonephric duct and accidentally encroaching on the ureteric bud position, resulted in the absence or dysplasia of the homolateral urinary tract and ectopic invasion of the bladder by the homolateral seminal tract.

Upper Tract Treatment of Urogenital Fistulas at the National Fistula Treatment Center (CNTF)

Introduction: Urogenital fistula is the existence of an abnormal pathway between a urinary organ and a genital organ. It is a public health problem because of its frequency and social aspect. The aim of this study was to analyse the management of urogenital fistulas by the upper route at the National Fistula Treatment Centre in N’Djamena. Material and Methods: This was a 10-year retrospective descriptive and analytical study from May 2011 to April 2021. The records of all patients who had received fistula treatment during this period were identified and analysed. Results: During the study period 2369 patients were managed for cure of urogenital fistula including 84 by the upper route, i.e. 3.5%. The mean age was 28.5 ± 8.13 years. Loss of urine was the most common reason for consultation (71.4%). Primigravida were represented in 50% (n = 42). The average gestational age was 3.2 ± 2.8 with extremes of 0 to 9 pregnancies. Obstetric aetiology was the most common (92.8%). Ureterovaginal fistulas were the most common anatomoclinical type (36.9%). Uretero-vesical reimplantation was the main surgical procedure (41.7%). Late postoperative follow-up was successful in 85.7% of cases. Conclusion: Urogenital fistulas are common in our practice. The only way to combat this scourge is through prevention through information, education and communication.

External anal sphincter electromyography in multiple system atrophy:implications for diagnosis,clinical correlations,and novel insights into prognosis

Multiple system atrophy is a sporadic,progressive,adult-onset,neurodegenerative disorder characte rized by autonomic dysfunction symptoms,parkinsonian features,and cerebellar signs in va rious combinations.An early diagnosis of multiple system atrophy is of utmost impo rtance for the proper prevention and management of its potentially fatal complications leading to the poor prognosis of these patients.The current diagnostic criteria incorporate several clinical red flags and magnetic resonance imaging marke rs supporting diagnosis of multiple system atrophy.Nonetheless,especially in the early disease stage,it can be challenging to differentiate multiple system atrophy from mimic disorders,in particular Parkinson’s disease.Electromyography of the external anal sphincter represents a useful neurophysiological tool for diffe rential diagnosis since it can provide indirect evidence of Onuf’s nucleus degeneration,which is a pathological hallmark of multiple system atrophy.However,the diagnostic value of external anal sphincter electromyography has been a matter of debate for three decades due to controve rsial reports in the literature.In this review,after a brief ove rview of the electrophysiological methodology,we first aimed to critically analyze the available knowledge on the diagnostic role of external anal sphincter electromyography.We discussed the conflicting evidence on the clinical correlations of neurogenic abnormalities found at external anal sphincter electro myography.Finally,we repo rted recent prognostic findings of a novel classification of electromyography patterns of the external anal sphincter that could pave the way toward the implementation of this neurophysiological technique for survival prediction in patients with multiple system atrophy.

Urogenital Trauma by Pelvic Impalement: A Case Reported at Bouake University Hospital

Urogenital impalement trauma is a particular form of penetrating trauma to the pelvis. They are rare, spectacular or dramatic because they can be responsible for serious vascular and/or visceral lesions. This study reports a case of hypogastric impalement in a 19-year-old young man that caused musculoaponeurotic and urogenital lesions. Emergency surgical exploration was carried out urgently by a multidisciplinary team.

Antibiotics Resistance of Urogenital Mycoplasma in Sexually Active Women Attending Gynecologic Consultation in Douala (Cameroon)

Introduction: Mycoplasmas are bacteria commonly found in the commensal flora of humans and can occasionally be pathogenic. The population and the geographical area determine their susceptibility to various antibiotics. Methodology: We carried out a cross-sectional study from January to June 2022 at the Douala General Hospital. All women who were sexually active and willing to participate were included. Endo-cervical swabbing was used to collect the samples. Culture and antibiotic susceptibility testing were performed in a liquid medium using Mycoplasma-SystemPlus Gallery (Liofilchem). All samples that degraded urea (threshold > 103 for Ureaplasma urealyticum) and arginine (threshold > 104 for Mycoplasma hominis) were deemed positive. Results: A total of 107 women with a median age of 33 ± 8.3 years and a predominance of 30-40 years (41.1%) were included. The frequency of mycoplasma infection was 73.8% with 34.1%, 11.4% and 54.4% for Ureaplasma urealyticum, Mycoplasma hominis and co-infection respectively. Resistance rates to Minocycline were low, 1.3% for Ureaplasma urealyticum and 3.7% for co-infection;for Pefloxacin the resistance rates were 3.7% (Ureaplasma urealyticum, Mycoplasma hominis) and 22.8% (co-infection). Ureaplasma urealyticum had a resistance rate of 3.7% for Erythromycin, 1.3% for Clarithromycin and 5% for Azithromycin. There was no significant correlation between risk factors and infection. Vaginal cleansing and the development of resistance in mycoplasma infection were found to be significantly correlated (OR = 6.915 [1.52 - 31.55];(p = 0.013)). Conclusion: Minocycline was the most active antibiotic and Ureaplasma urealyticum was the species with the lowest rate of resistance. Antibiotic resistance was more common in co-infected people than mono-infected. Antibiotic resistance was independently correlated with vaginal douching.

Epidemiologic and Therapeutic Aspect of Urogenital Fistula Following Obstetric and Gynecologic Surgeries Repaired at the Nkwen Baptist Hospital

Introduction: Urogenital fistula is an abnormal communication between the urinary and the genital systems. It may occur following vaginal deliveries or following pelvic surgeries. Data concerning urogenital fistula post-surgery is limited and we have noticed in recent years in Sub-Saharan Africa, an increase in the burden of iatrogenic urogenital fistula. Objective: The aim of this study was to assess the epidemiology, clinical profiles and therapeutic aspects of urogenital fistula following obstetric and gynaecologic surgeries repaired at the Nkwen Baptist Hospital Bamenda. Materials/Methods: This was a longitudinal descriptive study with a retrospective and prospective phase carried out at the Nkwen Baptist Hospital for 5 months. However the complete duration of the study was about 17 months. Data was collected using a pretested questionnaire containing socio-demographic information, clinical features, and therapeutic methods used. We used the statistical software SPSS (Social Package for Statistical Sciences) V 26.0 for data analysis. Results: The number of participants in the study was 40. The mean age was 43.5 years (+/- 13.3) ranging from 16 - 74 years. The prevalence of urogenital fistula post obstetric and gynecologic surgeries at the Nkwen Baptist hospital was 64.6%. The most common symptom was urine leakage and the most common surgery that exposed the patient to the urogenital fistula was total abdominal hysterectomy (60%) followed by caesarean section (35%). The different indications for these surgeries were mostly symptomatic leiomyoma (70.8 %) and prolonged labor (64.2%) respectively. The different types of fistula encountered were Vesicovaginal fistula (55%), Ureterovaginal fistula 40% and Vesicoutetrine fistula 5%. The different treatment modalities used were trans abdominal (77.5%) and transvaginal repair (22.5%). The overall repair success rate after one month was 85%. Conclusion: There is high burden of urogenital fistula post surgeries in our setting. Having more specialists trained in obstetric and gynaecologic procedures may help in the prevention of such an event.

Clinical Presentation, Therapeutic Aspects and Results of Urogental Prolapse in Yaounde

Introduction: Urogenital prolapse is the descent of one or more elements of the abdominal-pelvic contents into the vaginal cavity. The anterior, middle and posterior anatomical compartments may be involved giving rise to several types of genital prolapse. However, there are various therapeutic modalities ranging from observational procedures to surgery. In Yaounde, urogenital prolapse appears to be a rare clinical entity, and its treatment has not been clearly stated. There is limited data about this subject in our context. Our aim was to study the clinical and therapeutic aspects of urogenital prolapse in Yaounde. Methods: We conducted a descriptive cross-sectional study with retrospective data collection at the Yaounde Gynaecological Obstetric and Pediatric Hospital (YGOPH) and the Yaounde Central Hospital (YCH) over a period of 05 months (from February 2022 to June 2022). All women aged ≥30 years and all women with documented urogenital prolapse admitted to the maternity and urology departments of these two health facilities were included. Data were collected using a structured questionnaire. Data was analyzed using IBM SPSS (statistical package for social sciences) software version 23.0 and the data were reported as mean, standard deviation, frequencies and percentages. Results: A total of 50 patients were recruited;the mean age was 45.8 ± 17 years. The age range was from 21 to 72 years. Majority of the patients were aged more than 55 years (32%). Most of the patients attended primary education (48%). Forty percent of the patients were housewives. The majority of the patients were from West Cameroon (26%). The most common reason for consultation was pelvic heaviness (54%). The most prevalent clinical sign was cystocele (56%), followed by hysterocele (54%). According to the Baden Walker classification, one-third of the patients were classified as first degree (36%). More than half (58%) of patients had the condition located at the first stage. Surgery was performed in 68% of cases while 48% received medical treatment. The average length of inpatient stay was 7.9 ± 3.7 days and the average length of transurethral catheterization was 3.02 ± 2.9 days. Most patients had a good short-term outcome, and the main postoperative complications were infection (8.8%) and hemorrhage (5.9%). Conclusion: Urogenital prolapse is a rare condition in our population. Diagnosis is essentially clinical. Cystocele and hysterocele are the predominant clinical forms. Surgery is the mainstay of treatment. Outcomes are satisfactory.

Treatment for Persistent Chlamydial Infection in the Urogenital Tract-a Review Study

Objective： To investigate treatment efficacy for persistent chlamydial infection in the urogenital tract. Methods： 207 patients with persistent chlamydial urogenital infection were treated with tetracycline,azithromycin, ofloxacin or a combination of these.Result： 47.92%-68.60% of patients with persistent chlamydial urogenital infection were cured depending on the drug used. Ofloxacin had better results than tetracycline and azithromycin.Conclusion： Many patients were resistant to treatment with tetracycline and azithromycin. Ofloxacin proved effective.

Growing importance of urogenital candidiasis in individuals with diabetes:A narrative review

Both diabetes and fungal infections contribute significantly to the global disease burden,with increasing trends seen in most developed and developing countries during recent decades.This is reflected in urogenital infections caused by Candida species that are becoming ever more pervasive in diabetic patients,particularly those that present with unsatisfactory glycemic control.In addition,a relatively new group of anti-hyperglycemic drugs,known as sodium glucose cotransporter 2 inhibitors,has been linked with an increased risk for colonization of the urogenital region with Candida spp.,which can subsequently lead to an infectious process.In this review paper,we have highlighted notable virulence factors of Candida species(with an emphasis on Candida albicans)and shown how the interplay of many pathophysiological factors can give rise to vulvovaginal candidiasis,potentially complicated with recurrences and dire pregnancy outcomes.We have also addressed an increased risk of candiduria and urinary tract infections caused by species of Candida in females and males with diabetes,further highlighting possible complications such as emphysematous cystitis as well as the risk for the development of balanitis and balanoposthitis in(primarily uncircumcised)males.With a steadily increasing global burden of diabetes,urogenital mycotic infections will undoubtedly become more prevalent in the future;hence,there is a need for an evidence-based approach from both clinical and public health perspectives.

Urogenital Trauma: Epidemiological and Diagnostic Aspects at the Borgou University and Departmental Hospital Center (Benin)

Objective: To study the epidemiological and diagnostic aspects of urogenital trauma at the Borgou University and Departmental Hospital Center. Material and Methods: This was a descriptive cross-sectional study that took place over a period of 4 years and 4 months (52 months) from January 1st 2017 to April 30th 2021. All cases of urogenital trauma treated in the General surgery department during the period were collected. Patient records, hospitalization registers and operating reports were used to collect information. Data entry was done using Epi data 3.1 software, French version. The analysis was performed using MedCalc software (version 19.4.1. Mariakerke, Belgium), and Epi info software version 7. Results: In 52 months, 75 cases of urogenital trauma were collected. The prevalence of urogenital trauma was 1.1% of admissions with an annual incidence of 17.3 cases. The modal age class was [20;40], i.e. 49.3%. Males accounted for 76.0% (n = 57) of cases. Urethral and kidney injuries were found in 33.3% and 21.3%, respectively. The external genitalia was involved in 24.0%. Road traffic accidents occupied the first place with 62.6%. Kidney lesions were revealed by lumbar pain in 62.5% (n = 10) and post traumatic hematuria in 25% (n = 4) of cases. Most of the patients (n = 8, i.e. 50%) were classified as grade I according to the AAST classification. Conclusion: Urogenital trauma is common in our environment and can be life-threatening. Knowledge of their epidemiology will allow for prevention and good management.

Morphological characteristics of the lumbosacral spinal cord urogenital center in Sprague Dawley rats

BACKGROUND： Studies have demonstrated that selective innervation of the sacral nerve tract to the bladder plays an important role in bladder functional reconstruction following spinal cord injury. However, there are very few studies reporting detailed morphological characteristics of urogenital center and lumbosacral nerve roots. OBJECTIVE： To analyze the spinal cord segment of the lumbosacral spinal cord urogenital center, and to observe morphological characteristics. DESIGN, TIME AND SETTING： A neuroanatomical study was performed at the Laboratory of Neuroanatomy, Peking University Health Science Center between September 2007 and March 2008. MATERIALS： Horseradish peroxidase-conjugated cholera toxin B subunit （CB-HRP） was purchased from Sigma, USA; surgical microscope was purchased from Zhenjian Zhongtian Optical Instrument, Jiangsu Province, China; BCL-420 biological and functional experimental system was purchased from Taimeng Science and Technology, Sichuan Province, China. METHODS： A total of 36 adult, Sprague Dawley rats were randomly assigned to groups A （n = 10）, B （n = 10）, C （n = 10）, and D （n = 6）. CB-HRP （3%, 10-15 μL） was injected into the bladder detrusor muscle （group A）, external urethral sphincter （group B）, and perineal muscles （group C）, respectively. Rats in group D were not given any treatments. MAIN OUTCOME MEASURES： At 72 hours after CB-HRP injection, CB-HRP-positive neurons were analyzed in lumbosacral segments using 3, 3＇, 5, 5＇-tetramethylbenzidine staining and an Olympus optic microscope, while anatomical structures in the respective spinal nerve tract were observed using a surgical microscope. RESULTS： CB-HRP-positive neurons were distributed in the L6-S1 segments of the spinal cord, and neurons primarily innervating the bladder detrusor muscle were located at the sacral parasympathetic nucleus and the intermediolateral nucleus. In addition, neurons that primarily innervate the external urethral sphincter and perineal muscles were observed in the ventrolateral portion （Onuf＇s nucleus）. The lumbar-sacral nerve roots were composed of varying nerve tracts, Le., they were typically divided into 1-2 sub-bundles, and the sub-bundles were then divided into 2-3 tiny bundles. There were extensive fibro-connections between the rootlets. CONCLUSION： The urogenital center in Sprague Dawley rats was located in the L6 -S1 segments of the spinal cord, and the rootlets were clearly observed. Therefore, this rat experimental model could be utilized for highly selective anterior/posterior rhizotomy.

THE RELATION OF UREAPLASMA UREALYTICUM INFECTION TO UROGENITAL STONE FORMATION

Objective To study the mechanism of Ureaplasma urealyticum (UU) infection to the genesis of urogenital stone. Methods One hundred male SD rats were randomly divided into 3 groups: group A (n=45) rats were inoculated intravesically with 1ml (105 CCU/ml) of UU serotype 8 (T960) broth. Group B (n=22) rats were treated as the group A, 3 months later, administration of Minomycin (20~100mg/kg, oral daily for 14d) was given to each rat. Group C (n=33) rats were given sterile broth intravesically as control. After UU inoculation UU were collected from different parts of urogenital tract and cultured. In 3 testes positive in UU culture, UU specilic DNA fragments were tested by PCR technique. Results The percentages of positive UU culture in groop A animals were 87.5% in urinary bladders, 62.5% in testes, 55% in ePididymides, 65% in seminal vesicles, and 57.5% in prostates. The corresponding percentages in group B were significantly lower than that in group A (P<0.01). The incidences of bladder stones in groop A and B were 40% vs 35% (P>0.05). The main comPonent of stone was struvite (MgNH4PO4 6H2O). MicroscOPically, microlithes were found in seminderous tubules in 4 infected rats. In microlithes containing tubules, germinal cells and Sertoli cells were exfoliated or even absent. In some tubules, only membrana limitans remained intact. No microlithes found in testicular interstitial tissue. Cooclusion UU infection does induce urogenital stones and Minomycin can inhibit UU growth. With interlerence on spermatogenesis, UU may be one of the causes of male inlertility.

Urogenital Infections in the Male and Their Implications on Fertility

Male infertility is a clinical manifestation which concerns approximately 15 % of all couples in Europe. Male causes for infertility are found in 50% of involuntarily childless couples. For Germany this counts for a number of an equivalent of 50 000 men/year, No causal factor is found in 60%-75% of cases （idiopathic male infertility）. Nevertheless, reduced male fertility can be the result of congenital and acquired urogenital abnormalities, increased scrotal temperature （varicocele）, endocrine disturbances, genetic abnormalities and immunological factors. Furthermore, urogenital inflammations and infections play an important role. Indications for microbiological assessment include abnormal urine samples, urinary tract infections, prostatitis, epididymitis, orchitis, ejaculate infections and sexually transmitted diseases. In the following review, different infectious diseases of the male urogenital tract and their implications on fertility were reviewed.

A Novel Technique for Removal of Urogenital Magnetic Foreign Bodies

Background: There were 800 individual case reports of urogenital foreign bodies in the English literature from 1755 to 1999. The use of urogenital foreign bodies for sexual pleasure is a common occurrence in today’s population. The aim of this discussion is the management of scrotal injury caused by magnetic urogenital foreign bodies. Case Presentation: 56-year-old male with scrotal tissue entrapped between two opposed magnet rings. Self-reported attempts at removal were unsuccessful and caused for presentation to the emergency department. Additional attempts at removal by medical staff unsuccessful in emergency department and therefore the patient proceeded to the operating room. Intraoperatively the use of two cardiac magnets allowed for removal without a need for invasive surgical procedure. Conclusion: Cardiac magnets are preferred means of removal for entrapped skin between magnetic foreign bodies that could be utilized at the bedside.

Research progress of of RNA m6 A methylation in urogenital tumors

TRNA m6A methylation is a kind of dynamic reversible modification commonly existing in eukaryotes. It is involved in three proteins, namely m6A methyltransferase, m6A demethylase and m6A binding protein, which regulate RNA shearing, transport, stability and translation into proteins. It is closely related to many physiological processes, especially in tumors. However, there are few studies on RNA m6A methylation in urogenital tumors. Therefore, this article reviews the role of RNA m6 A methylation in tumors and its research progress in the urogenital system.

A Clinical Research about the Intermittent Medication Treatment on the Female Urogenital Tract Mycoplasma Infection

Object: To explore a better treatment on the female urogenital tract mycoplasma infection so as to ensure the health of female reproduction. Method: 115 female patients with urogenital tract?mycoplasma infection?are selected, including 63 patients acted as a group for intermittent medication treatment;that is to say, the ones that are confirmed to be sensitive drugs to those 63 patients are chosen, and let them take this medication for 15 days and stop taking it for 7 days and after that continue to take it for 10 days. The other 52 patients in the other group which acts as a contrast to the former group are cured with a course of conventional treatment for 15 - 21 days. Results: As to those 115 female patients with urogenital tract mycoplasma infection, 43 patients get relapsed, and 27 patients of them are in the contrast group and 16 patients are in the treatment group.?There is obvious difference on the contrast of relapse rate between the treatment group and contrast group, and they are P < 0.01. But as to the sensitive testing results of 10 common antibiotic medicines, there are cases of illness of relapse in those 2 groups, and the rate of drug sensitivity in the treatment group is higher than that of the contrast group. Between treatment group and contrast group, there is obvious difference in the sensitivity of the drugs, P < 0.05 average. Conclusion: When the female patients with urogenital tract mycoplasma infection are cured with a traditional treatment, because of the side effects of drugs, they are not likely to take medicines that are required to making the cure rate become lower and the relapse rate become higher. But intermittent medication is designed with the half-life period of medicine, which makes the medicine can be digested and absorbed easily, and the cure rate is high and the relapse rate is low. With this research we found a more effective method of the treatment on the female urogenital tract mycoplasma infection and showed the clinical significance in intermittent medication.

Results of the Management of Urogenital Fistulae from Community Caravans

Objective: To report the experience of surgical caravans for urogenital fistulas care. Methodology: This was a retrospective study covering the period from January 2014 to December 2014 and which took place on 7 sites of fistula care. The epidemiological, anatomoclinical, therapeutic and evolutionary aspects were studied. Results: 346 patients were operated during 14 caravans. Their average age was 33.11 years (range: 12 to 70 years). Most of these patients were without remunerative activities (80%) and without education (63.3%). The average duration of fistula progression was 6.08 years (range: 0 to 42 years). Obstetrical etiology was predominant (87.9%). According to the classification of Kees Waaldijk, fistulas were divided into type I (67.4%), type II (21.1%), and type III (11.5%). The most common surgical approach was the transvaginal route (82.1%). The vesicovaginal splitting with separated suture of the bladder and the vagina was the basic technique (94.7%). The therapeutic results were judged after a follow-up of 1 month and 3 months. Across the cohort, 80 patients (23.1%) were lost of sight for follow-up at 1 month and 245 (70%) at 3 months. The success rates evaluated in patients reviewed at 1 month and 3 months were respectively 70% and 64%. Conclusion: The incidence of urogenital fistulas is still high in Cote d'Ivoire. Various anatomoclinical varieties have been identified and treated with satisfactory results in poorly equipped local structures.

Global Rates and Prevalence of Urogenital Mycoplasmosis: Assembly of a Dataset from Peer-Reviewed Literature

Rates of urogenital mycoplasmosis associated with Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma urealyticum, and Ureaplasma parvum have been reported numerous times, and frequently show a wide range of findings. Differing diagnostic techniques, population targeting, temporal and spatial data collection, and coincident infections make the conclusions from these analyses difficult to compare. We generated a single data set including the infection rate, geographic location, year, study population, diagnostic method, and clinical signs for these organisms by performing literature searches with the species names and compiling the findings. Studies focusing on basic research or reporting clinical surveys where these criteria were not reported were excluded. A statistical analysis of the dataset parameters found that: diagnostic method does not significantly correlate with positive specimen rate but does correlate with the year of publication, and the number of publications correlated significantly with year, indicating that this topic is of growing interest. Further analysis indicated that Ureaplasma species infection rate is significantly higher in pregnant women across all studies. Associations with distinct clinical presentation could not be made on datasets assembled across studies due to the number of confounding variables presented in each. The generated data set represents a large amount of temporal, geographic, and clinical data that can be utilized in future communications.

Urogenital Fistula in Cote d’Ivoire: Epidemiological, Clinical and Therapeutical Aspects

Goal: Contribute to improve treatment of patients suffering from urogenital fistula (UGF). Materials and methods: It was a descriptive and prospective study conducted by the United Nations Population Fund (UNFPA) and the Ivorian government, on treatment of fistulas. The caravan took place on 4 periods of 10 days each and has enabled us to recruit 95 patients in the gynecological emergency department of Bouake’s University Hospital Center (UHC) and from the surgical emergencies departments of the regional hospital centers (RHC) of Man and Bondoukou, in Man from 14th to 23rd of August 2013, then from 24th March to 02nd of April 2014;in Bouaké from 06th to 15th of November 2013 and in Bondoukou from 13th to 22nd of December 2013, respectively. Results: Average age of patients was of 30.8 years. 50 patients were single (52.6%). 44.2% of patients were farmers. In 95.8% of cases it was about obstetrical fistulas of which 52.6% were caused by caesareans. Average duration of delivery labor was of 2.3 days. Vesicovaginal fistulas represented 65.3% of UGF. Suture split were carried out on 90 patients (94.7%). Within 01 month, success rate was of 63.9% for 83 known patients. Conclusion: Incidence of UGF in our country is certainly underestimated. They are mainly of obstetrical origin and treatment relies on sutures split which give satisfactory results.

Health, Wellbeing and Self-Esteem: Web-Based Support in Children with Urogenital or Bowel Malformation

Children with urogenital malformation or bowel disturbances are a vulnerable group and are at risk of experiencing ill health. At school they have to face and cope with situations they are unused to and often feel excluded. There is a lack of studies investigating prevention of ill health in this group of children. Objective: The aim of the study was to investigate the health/well-being and self-esteem, before and after a one-year intervention comprising person-centred, web-based learning support, in preschool children born with malformations in the urethra, bladder, genitals and/or bowel. Study design: Nine boys and one girl participated, aged 3 - 7 years (study group) with diagnoses of epispadia, bladder exstrophy, urethra valves and Hirschprung’s disease. Two questionnaires were used, developed to measure index of health/wellbeing and self-esteem in younger children. In the study group, the interviews were repeated after one year. The group was compared with a control group of 20 healthy, age-matched children. Results: Before the intervention, there were no differences in wellbeing (Children condition index) between the study group and the control group. One year after the start of the web-based preschool, wellbeing in the study group had slightly improved, but not significantly compared to before the intervention. No significant difference was found compared to the control group. When measured self-esteem (I think I am) before the intervention, the study group had significantly better self-esteem compared to the control group. One year later, there was a slight improvement in self-esteem, but two children scored worse in the domain Psychological wellbeing. In comparison with the group of healthy children, the self-esteem in the study group was better for total sum (p = 0.0002). Discussion: Wellbeing and self-esteem seem to be good in children aged 3 - 7 years with uro-genital and bowel malformations, according to the findings of this study. This is better than reports concerning older children. Despite high initial values compared to healthy children, continued, but not significant, improvement in wellbeing and self-esteem was shown one year after intervention. Conclusions: The results of the intervention aimed at promoting health, wellbeing and self-esteem are promising but a longer-term follow-up in a larger group of children is needed.