The purpose of this research study is to evaluate an Enhanced Recovery After Surgery (ERAS) protocol in children and young adults undergoing urologic reconstructive surgery. The investigators plan to collect data on speed of recovery (how quickly pain improves, length of time in the hospital, and the need for additional pain control) on patients who receive care under the ERAS protocol and compare it to historical controls.

Population

There are 2 populations: 1. ERAS patients: a. ages 4-17 and, b. transitional young adult 18-25 2. Historical patients: a. ages 4-17 and, b. transitional young adult 18-25

Brief Title

Pediatric Urology Recovery After Surgery Endeavor (PURSUE)

Official Title

Multicenter Pilot and Exploration Study of Enhanced Recovery After Surgery (ERAS) in Patients Undergoing Urologic Reconstructive Surgery

Brief Summary

The purpose of this research study is to evaluate an Enhanced Recovery After Surgery (ERAS) <br /> protocol in children and young adults undergoing urologic reconstructive surgery. The <br /> investigators plan to collect data on speed of recovery (how quickly pain improves, length of <br /> time in the hospital, and the need for additional pain control) on patients who receive care <br /> under the ERAS protocol and compare it to historical controls.

Detailed Description

The purpose of this project is to evaluate Enhanced Recovery After Surgery (ERAS) in the
pediatric setting for participants undergoing intraabdominal urologic reconstruction
procedures. ERAS practices are being implemented in the department independent of research
and this project will allow the investigators to review these practices.

Providers, participants, and family members will complete pre- and post- surgery
questionnaires. These questionnaires are geared to collect demographic information about the
participant and how the surgery affects their life situation. The providers will answer
questions regarding their experience with ERAS.

Evidence-based ERAS principles and procedures are compulsory components of this project.
These will be documented in the medical record and are considered standard of care practice
as part of perioperative patient care.

Data collected from the medical record for each participant will aid in evaluating if
adherence to the ERAS protocol is achieved.

Outcome Measures

Outcome measures are the tests that investigators perform to prove whether or not a treatment being tested in a clinical trial is having any effect.

Inclusion criteria:

  -  Age greater than or equal to 4 or <26 years at time of surgery

  -  Undergoing urologic reconstructive surgery that includes primary bowel anastomosis
     (i.e., creation of continent ileovesicostomy [Monti], sigmoid Monti channel,
     enterocystoplasty)

  -  Undergoing urologic reconstructive surgery that includes possible bowel anastomosis
     (planned creation of continent appendicovesicostomy [Mitrofanoff] with inability to
     use appendix at time of surgery and creation of alternative channel requiring primary
     bowel anastomosis)

Exclusion criteria:

• Clinically constipated (defined as Bristol 1 or 2 stools more than once per week, bowel
movement interval > every other day [e.g. only has bowel movement every 3 days, or palpable
stool in > 50% of colon on physical preoperative exam)