Nicholas Faure Walker1, Bradley Gill2, Jonathan Olsburgh3, David Gillatt4, Tet Yap3, Lina Michala5, Claire Taylor3,6, Hadley Wood2, Dan Wood7. 1. Concord Institute of Academic Surgery, Concord Repatriation General Hospital, Sydney, NSW, 2139, Australia. Nicholas.faure.walker@gmail.com. 2. Department of Urology, Glickman Urological and Kidney Institute, Lerner College of Medicine, Cleveland Clinic, Cleveland, OH, USA. 3. Guys and St Thomas NHS Foundation Trust, Great Maze Pond, London, SE1 9RT, UK. 4. Macquarie University Hospital, Macquarie University, 3 Technology Place, Sydney, NSW, 2109, Australia. 5. National and Kapodistrian University of Athens, Lourou 2, 115 28, Athens, Greece. 6. King's College Hospital, Denmark Hill, London, SE5 9RS, UK. 7. University College London Hospitals, 16-18 Westmoreland Street, London, W1H 6PL, UK.
Abstract
PURPOSE: Improved medical care throughout childhood and adolescence has enabled patients with complex urological abnormalities to live longer into adulthood. These patients are now at risk of developing common, age-related, urological conditions. This review aims to review existing data and make recommendations in areas where expert opinion is currently lacking METHODS: This review represents the joint SIU-ICUD (Société Internationale d'Urologie-International Consultation on Urological Disease) consultation on congenital lifelong urology. The results of this analysis were first presented at a joint consultation of the ICUD and SIU at the 2018 SIU annual conference in Seoul, South Korea. RESULTS: BPH may present differently in patients with neurogenic bladder. Thorough assessment of neurological status, bladder and sphincter function is required before offering any bladder outlet surgery. Prostate specific antigen screening should be offered to men aged 50-69 with neurogenic bladders if they have good life expectancy. Multi-parametric MRI and transperineal biopsy would be the investigations of choice if feasible. Surgery for localized disease should only be done by surgeons with the relevant expertise. Bladder cancer in this patient group is more likely to present at a later stage and have a worse prognosis. Parenthood is achievable for most, but often requires assistance with conception. Pregnant women who have had previous urogenital reconstructive surgery should be managed in appropriate obstetric units with the involvement of a reconstructive urologist. CONCLUSIONS: Most evidence regarding complex urogenital abnormalities comes from the pediatric population. Evidence regarding common, age-related urological issues is generally from the 'normal' adult population. As patients with complex congenital urological conditions live longer, more data will become available to assess the long-term benefits of intervention.
PURPOSE: Improved medical care throughout childhood and adolescence has enabled patients with complex urological abnormalities to live longer into adulthood. These patients are now at risk of developing common, age-related, urological conditions. This review aims to review existing data and make recommendations in areas where expert opinion is currently lacking METHODS: This review represents the joint SIU-ICUD (Société Internationale d'Urologie-International Consultation on Urological Disease) consultation on congenital lifelong urology. The results of this analysis were first presented at a joint consultation of the ICUD and SIU at the 2018 SIU annual conference in Seoul, South Korea. RESULTS:BPH may present differently in patients with neurogenic bladder. Thorough assessment of neurological status, bladder and sphincter function is required before offering any bladder outlet surgery. Prostate specific antigen screening should be offered to men aged 50-69 with neurogenic bladders if they have good life expectancy. Multi-parametric MRI and transperineal biopsy would be the investigations of choice if feasible. Surgery for localized disease should only be done by surgeons with the relevant expertise. Bladder cancer in this patient group is more likely to present at a later stage and have a worse prognosis. Parenthood is achievable for most, but often requires assistance with conception. Pregnant women who have had previous urogenital reconstructive surgery should be managed in appropriate obstetric units with the involvement of a reconstructive urologist. CONCLUSIONS: Most evidence regarding complex urogenital abnormalities comes from the pediatric population. Evidence regarding common, age-related urological issues is generally from the 'normal' adult population. As patients with complex congenital urological conditions live longer, more data will become available to assess the long-term benefits of intervention.
Authors: Inga Soveri; Ulla B Berg; Jonas Björk; Carl-Gustaf Elinder; Anders Grubb; Ingegerd Mejare; Gunnar Sterner; Sten-Erik Bäck Journal: Am J Kidney Dis Date: 2014-05-17 Impact factor: 8.860
Authors: M Verhoef; M Lurvink; H A Barf; M W M Post; F W A van Asbeck; R H J M Gooskens; A J H Prevo Journal: Spinal Cord Date: 2005-06 Impact factor: 2.772
Authors: Andrew S Levey; Josef Coresh; Tom Greene; Lesley A Stevens; Yaping Lucy Zhang; Stephen Hendriksen; John W Kusek; Frederick Van Lente Journal: Ann Intern Med Date: 2006-08-15 Impact factor: 25.391
Authors: Marina L Reppucci; Lea A Wehrli; Duncan Wilcox; Jill Ketzer; Alberto Pena; Luis de la Torre; Andrea Bischoff; Dan Wood Journal: Pediatr Surg Int Date: 2022-09-23 Impact factor: 2.003