scarring. We describe robotic ureteroplasty with buccal mucosa graft (BMG) for the management of recurrent proximal and middle ureteral strictures after previously failed ureteral reconstruction. METHODS: We retrospectively reviewed our institutional ureteral reconstruction database to identify patients who underwent robotic ure- teroplasty with BMG between 9/2014 and 10/2017 for a recurrent proximal or middle ureteral stricture after a previously failed ureteral reconstruction. Our technique involved a focused ureterolysis to expose the disease segment of ureter. In cases of severe peri-ureteral fibrosis, only the ventral aspect of the ureter was dissected and the dorsal aspect was left un- manipulated. Extensive ureteral mobilization was unnecessary. The diseased ureteral segment was sharply incised on its ventral surface, along the longitudinal axis. BMG was onlayed onto the ventral ureterotomy and anastomosed. The reconstructed ureter was then isolated with an omental flap. All patients were assessed for: clinical success, the absence of flank pain; and radiological success, the absence of obstruction on renal scan. RESULTS: Of 11 eligible patients, 5/11 (45.5%) had right-sided strictures, 9/11 (81.8%) had proximal strictures, and the median length of stricture was 2.5 centimeters (IQR 2-3.25). The median length of BMG harvested was 3 centimeters (IQR 2.8-4), median operative time was 226 minutes (IQR 194-262), and median estimated blood loss was 100 milliliters (IQR 80-100). The median length of stay was 1 day (IQR 1-2) day, and there were no postoperative complications (Clavien >2). At a median follow-up of 12 months (IQR 6-21), 10/11 (90.1%) patients were clinically and radiologically successful. CONCLUSIONS: Robotic ureteroplasty with BMG is effective in managing recurrent ureteral strictures after failed ureteral re- constructions. The technique allows for a focused ureteral dissection which obviates the need for an extended ureterolysis and minimizes disruption to the peri-ureteral blood supply. Source of Funding: None PD43-10 THE EFFECTS OF AUGMENTATION CYSTOPLASTY AND BOTULINUM TOXIN INJECTION ON PATIENT-REPORTED BLADDER FUNCTION AND SATISFACTION AMONG SPINAL CORD INJURY PATIENTS PERFORMING INTERMITTENT CATHETERIZATION Jeremy Myers*, Sara Lenherr, Salt Lake City, UT; John Stoffel, Ann Arbor, MI; Sean Elliott, Minneapolis, MN; Angela Presson, Chong Zhang, Salt Lake City, UT; Blayne Welk, London, Canada INTRODUCTION AND OBJECTIVES: Clean intermittent cathe- terization (CIC) is the bladder management strategy recommended by cli- nicians after spinal cord injury (SCI) because it has the least complications. However, dissatisfaction with CIC is evident by high rates of switching to other forms of bladder management over time, mostly to indwelling cathe- ters. We hypothesize that interventions such as bladder botulinum toxin in- jection or augmentation cystoplasty can improve satisfaction with CIC. METHODS: The NBRG registry is a multicenter, prospective, observational study asking SCI participants about neurogenic bladder related quality of life. Eligibility included: age >18 years and acquired SCI. Over 1.5 years, 1479 participants enrolled. From this cohort, those per- forming CIC as primary bladder management were categorized into 3 groups: 1) CIC-alone, 2) CIC using botulinum toxin (CIC-BTX), and 3) CIC with augmentation cystoplasty (CIC-AUG). Multivariate linear regression was used, controlling for multiple factors, to establish differences in the Neurogenic Bladder Symptom Score (NBSS), its sub-domains (Inconti- nence, Storage & Voiding, and Consequences), and the final question of the NBSS (satisfaction with urinary function) between the 3 groups. The mean, across groups, for each measure was reported as a point of reference for the magnitude of change. A negative change for the NBSS indicates improvement in function / satisfaction. Values were reported with standard deviation and 95% confidence intervals. RESULTS: 879 participants identified CIC as their primary bladder management. The mean age was 43.4 (Æ12.9) and mean years from injury was 13.7 (Æ10.7). Level of injury was tetraplegia in 284 (32%); 337 (38%) were women. Bladder management was CIC-alone in 593 (67%), CIC-BTX in 161 (19%), and CIC-AUG in 125 (15%). Total NBSS (mean 25Æ10.1) did not differ between CIC-alone and CIC-BTX but was improved for CIC-AUG (-3.9 (-5.9 e -1.8, p<0.001). Similarly, the Incontinence subdomain (mean 10.4Æ6.8) did not differ between CIC-alone and CIC-BTX but was improved in CIC-AUG (-2.82(-4.14 e -1.49), p<0.001). There were no differences be- tween groups in the other 2 NBSS subdomains. Satisfaction with urinary function (mean 2.1Æ1.2) did not differ between CIC-alone and CIC-BTX, but was improved in CIC-AUG (-1.11(-1.43 e -0.8), p<0.001). CONCLUSIONS: Individuals performing CIC after SCI had the best urinary function and satisfaction after augmentation cystoplasty. Source of Funding: Patient Centered Outcomes Research Institute (PCORI) CER14092138. PD43-11 THE LONG-TERM OUTCOMES OF AUGMENTATION CYSTOPLASTY AT 20-30 YEARS FOLLOW UP Anastasia Frost*, Simon Bugeja, Mariya Dragova, Daniela Andrich, Anthony Mundy, Reading, United Kingdom INTRODUCTION AND OBJECTIVES: Many concerns are still raised as to the long-term outomes of patients having undergone cystoplasty many years ago, particularly related to preservation of renal function and continence amongst others. This study aims to address these issues. METHODS: 126 patients underwent cystoplasty by a single surgeon and were followed up in the long-term (20-30years; mean 24.8years). 83(66%) also had an artificial sphincter (AUS). These 126 formed part of an original cohort of 267 patients followed up for a minimum of 10 years. Functional outcome and complications were recorded at both follow-up milestones and compared. RESULTS: At 10 years, continence rates of up to 75% are main- tained, rising to 90% with an AUS. With longer follow-up, continence rates drop, and AUS-related problems become the most significant (63 of 83 patients; 76%) compared to 15 cystoplasty-related complications in 43pa- tients (35%). Most problems occur between 10 and 15 years. Growth and other metabolic issues and bowel dysfunction are rarely a problem even in the long-term. Renal function remains normal in patients with spina bifida but declines in patients with acquired neuropathic disorders and congenital anatomical anomalies. No malignant transformation has been detected to date in these patients. Stones (22%, mainly in patients self-catheterising) and recurrent urinary tract infections (22%) remain a persistent complication. CONCLUSIONS: The commonest problems in the long-term in these patients are not related to the cystoplasty itself but to their AUS. Many are indeed unsalvageable after multiple AUS revsions and a significant proportion end up either incontinent, catheterise to maintain continence or undergo urinary diversion. Most complications are pre- dictable but unavoidable. Source of Funding: none PD43-12 KIDNEY TRANSPLANT RECIPIENTS WITH BLADDER AUGMENTATION AND WITHOUT URINARY RECONSTRUCION: SIMILAR OUTCOMES? Kleiton Yamaçake, Affonso Piovesan, Renato Falci, Gustavo Messi, Ioannis Antonopoulos, Marcos Mello*, Eder Nisi Ilario, Hideki Kanashiro, William Nahas, Sao Paulo, Brazil INTRODUCTION AND OBJECTIVES: The aim of this study was to compare the results of kidney transplant (KT) in patients with bladder augmentation (BA) and without urinary reconstruction. METHODS: Between 1988 and 2015, 64 patients with BA (3 after KT) underwent kidney transplantation, due to significant lower uri- nary tract dysfunction. There were 40 males and 24 females. Ten second and 1 third KT were performed, comprising 75 KT in 64 patients. 44 were from living donor and 31 from deceased donor. 4410 KT in non recon- structed patients were performed at the same period. Comparison regarding overall patient survival and graft survival was carried out. In BA group, mean age at 1st transplantation was 22.54Æ15.09 (3-64) years e880 THE JOURNAL OF UROLOGY â Vol. 199, No. 4S, Supplement, Sunday, May 20, 2018