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Advances and Challenges in Transitional Urology: Caring for Adolescents and Young Adults with Lifelong Complex Genitourinary Conditions

  • Pediatric Urology (D Weiss, Section Editor)
  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

As long-term survival with complex congenital and pediatric diseases has improved, more patients with congenital genitourinary conditions are living into adulthood. These patients can continue to face lifelong issues related to their conditions, including urinary incontinence, recurrent urinary tract infections, chronic kidney disease, and difficulties with sexual health and function.

Recent Findings

The practice of transitional urology continues to grow nationwide and abroad, and it will be important to develop evidence-based practices for coordinated transition of these patients into the adult health care setting.

Summary

This review describes the broader attention to transitions of care in medicine and specifically evaluates spina bifida as a model disease system for implementation of transitional practices in urology.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Burdo-Hartman WA, Patel DR. Medical home and transition planning for children and youth with special health care needs. Pediatr Clin N Am. 2008;55:1287–97.

    Article  Google Scholar 

  2. Swanson ME. Need for the life course model for SB. Pediatr Clin N Am. 2010;57:893–901.

    Article  Google Scholar 

  3. • McManus MA, et al. Current status of transition preparation among youth with special needs in the United States. Pediatrics. 2013;131:1090–7. This article provides a data-driven picture of the current state of transitional care in the USA for all young adults with chronic pediatric medical conditions. It is not restricted to patients with urologic conditions, but gives an excellent idea of the hurdles all providers face in implementing successful transitions of care.

    Article  PubMed  Google Scholar 

  4. American Academy of Pediatrics, American Academy of Family Physicians & American College of Physicians-American Society of Internal Medicine. A consensus statement on health care transitions for young adults with special health care needs. Pediatrics. 2002;110:1304–6.

    Google Scholar 

  5. Rosen DS, Blum RW, Britto M, Sawyer SM, Siegel DM. Transition to adult health care for adolescents and young adults with chronic conditions. J Adolesc Health. 2003;33:309–11.

    Article  PubMed  Google Scholar 

  6. Grimsby GM, Burgess R, Culver S, Schlomer BJ, Jacobs MA. Barriers to transition in young adults with neurogenic bladder. J Pediatr Urol. 2016;12:258.e1–5.

    Article  CAS  Google Scholar 

  7. Carrasco A, Vemulakonda VM. Managing adult urinary incontinence from the congenitally incompetent bladder outlet. Curr Opin Urol. 2016;26:351–6.

    Article  PubMed  Google Scholar 

  8. •• Loftus CJ, Wood HM. Congenital causes of neurogenic bladder and the transition to adult care. Transl Androl Urol. 2016;5:39–50. This article is a comprehensive review of the medical issues and approaches to management that young adults with congenital genitourinary conditions may face in early adulthood. Drs. Loftus and Wood draw on the Cleveland Clinic’s rich experience in transitional urology to give guidance to the field in issues of medical decision-making.

    PubMed  PubMed Central  Google Scholar 

  9. Chan R, Scovell J, Jeng Z, Rajanahally S, Boone T, Khavari R. The fate of transitional urology patients referred to a tertiary transitional care center. Urology. 2014;84:1544–8.

    Article  PubMed  PubMed Central  Google Scholar 

  10. • Snow-Lisy DC, Yerkes EB, Cheng EY. Update on urological management of SB from prenatal diagnosis to adulthood. J Urol. 2015;194:288–96. The urology team at Northwestern/Lurie Children’s Hospital review current practices in medical and surgical care of patients with SB throughout the life cycle. In discussing the current state of practice, they also address contemporary debates in the management of these patients in a thoughtful manner.

    Article  PubMed  Google Scholar 

  11. Dillon C, Davis B, Duguay S, Seidel K, Shurtleff D. Longevity of patients born with myelomeningocele. Eur J Pediatr Surg. 2000;10:33–4.

    Article  PubMed  Google Scholar 

  12. Wang Y, Hu J, Druschel CM, Kirby RS. Twenty-five-year survival of children with birth defects in New York state: a population-based study. Birth Defects Res A Clin Mol Teratol. 2011;91:995–1003.

    Article  CAS  PubMed  Google Scholar 

  13. Young N, McCormick A, Mills W, Barden W, Boydell K, Law M, et al. The transition study. Phys Occup Ther Pediatr. 2006;26:25–45.

    PubMed  Google Scholar 

  14. Kinsman SL, Doehring MC. The cost of preventable conditions in adults with SB. Eur J Pediatr Surg. 1996;6(Suppl 1):17–20.

    Article  PubMed  Google Scholar 

  15. Ahmad I, Granitsiotis P. Urological follow-up of adult SB patients. Neurourol Urodyn. 2007;26:978–80.

    Article  PubMed  Google Scholar 

  16. Singhal B, Mathew K. Factors affecting mortality and morbidity in adult SB. Eur J Pediatr Surg. 1999;9:31–2.

    Article  PubMed  Google Scholar 

  17. Hunt GM. Open SB: outcome for a complete cohort treated unselectively and followed into adulthood. Dev Med Child Neurol. 1990;32:108–18.

    Article  CAS  PubMed  Google Scholar 

  18. Crowley R, Wolfe I, Lock K, McKee M. Improving the transition between paediatric and adult healthcare: a systematic review. Arch Dis Child. 2011;96:548–53.

    Article  CAS  PubMed  Google Scholar 

  19. Lawrenson R, Wyndaele JJ, Vlachonikolis I, Farmer C, Glickman S. Renal failure in patients with neurogenic lower urinary tract dysfunction. Neuroepidemiology. 2001;20:138–43.

    Article  CAS  PubMed  Google Scholar 

  20. Duplisea JJ, Romao RLP, MacLellan DL, Cox AR, Anderson PA. Urological follow-up in adult SB patients: is there an ideal interval? Urology. 2016;97:269–72.

    Article  PubMed  Google Scholar 

  21. Lambert SM. Transitional care in pediatric urology. Semin Pediatr Surg. 2015;24:73–8.

    Article  PubMed  Google Scholar 

  22. Rove KO, Higuchi TT. Monitoring and malignancy concerns in patients with congenital bladder anomalies. Curr Opin Urol. 2016;26:344–50.

    Article  PubMed  Google Scholar 

  23. Austin JC, Elliott S, Cooper CS. Patients with SB and bladder cancer: atypical presentation, advanced stage and poor survival. J Urol. 2007;178:798–801.

    Article  PubMed  Google Scholar 

  24. Bong GW, Rovner ES. Sexual health in adult men with SB. Sci World J. 2007;7:1466–9.

    Article  Google Scholar 

  25. Cass AS, Bloom BA, Luxenberg M. Sexual function in adults with myelomeningocele. J Urol. 1986;136:425–6.

    Article  CAS  PubMed  Google Scholar 

  26. Palmer JS, Kaplan WE, Firlit CF. Erectile dysfunction in SB is treatable. Lancet. 1999;354:125–6.

    Article  CAS  PubMed  Google Scholar 

  27. Palmer JS, Kaplan WE, Firlit CF. Erectile dysfunction in patients with SB is a treatable condition. J Urol. 2000;164:958–61.

    Article  CAS  PubMed  Google Scholar 

  28. Overgoor MLE, de Jong TPVM, Cohen-Kettenis PT, Edens MA, Kon M. Increased sexual health after restored genital sensation in male patients with SB or a spinal cord injury: the TOMAX procedure. J Urol. 2013;189:626–32.

    Article  CAS  PubMed  Google Scholar 

  29. Dicianno BE, Kurowski BG, Yang JMJ, Chancellor MB, Bejjani GK, Fairman AD, et al. Rehabilitation and medical management of the adult with SB. Am J Phys Med Rehabil. 2008;87:1027–50.

    Article  PubMed  Google Scholar 

  30. Summers SJ, Elliott S, McAdams S, Oottamasathien S, Brant WO, Presson AP, et al. Urologic problems in SB patients transitioning to adult care. Urology. 2014;84:440–4.

    Article  PubMed  Google Scholar 

  31. Szymanski KM, Cain MP, Hardacker TJ, Misseri R. How successful is the transition to adult urology care in SB? A single center 7-year experience. J Pediatr Urol. 2017;13:40.e1–6.

    Article  Google Scholar 

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Authors and Affiliations

  1. Division of Urology, University of Pennsylvania Health System, 3400 Civic Center Blvd, 3rd Floor - West Pavilion, Philadelphia, PA, 19104, USA

    Alexander J. Skokan & Robert Caleb Kovell

  2. University of Pennsylvania Health System and the Children’s Hospital of Philadelphia, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA

    Robert Caleb Kovell

Authors
  1. Alexander J. Skokan
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  2. Robert Caleb Kovell
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Corresponding author

Correspondence to Robert Caleb Kovell.

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Conflict of Interest

Alexander J. Skokan and Robert Caleb Kovell each declare no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Pediatric Urology

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Skokan, A.J., Kovell, R.C. Advances and Challenges in Transitional Urology: Caring for Adolescents and Young Adults with Lifelong Complex Genitourinary Conditions. Curr Urol Rep 19, 26 (2018). https://doi.org/10.1007/s11934-018-0774-3

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  • DOI: https://doi.org/10.1007/s11934-018-0774-3

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