Matthieu Peycelon1,2, Rosalia Misseri3. 1. Department of Pediatric Urology, Riley Children Hospital at Indiana University Health (IHU), Indiana University School of Medicine, 705 Riley Hospital Drive, ROC Suite #4230, Indianapolis, IN, 46202, USA. mpeycelo@iu.edu. 2. Department of Pediatric Surgery and Urology; Reference Center for Rare Diseases (CRMR) Malformations Rares Des Voies Urinaires (MARVU), AP-HP, Hôpital Universitaire Robert-Debré Université Paris Diderot, Sorbonne Paris Cité, Paris, France. mpeycelo@iu.edu. 3. Department of Pediatric Urology, Riley Children Hospital at Indiana University Health (IHU), Indiana University School of Medicine, 705 Riley Hospital Drive, ROC Suite #4230, Indianapolis, IN, 46202, USA.
Abstract
PURPOSE: Transition in urology is defined by the process that allows an adolescent or a young adult with a congenital or acquired urogenital anomaly to assume increasing responsibility for their own health care and to become the primary decision maker in their care. METHODS: A review of the literature regarding transitional care for lifelong urologic congenital anomalies was performed with the aim of reporting expert opinion when data are non-existent. This review focuses on special considerations for adolescents and young adults with spina bifida, bladder exstrophy, anorectal malformations and differences of sexual development. RESULTS: Urologic goals during the transition from childhood to adulthood continue to include attention to the preservation of renal function and optimization of lower urinary tract function. Additional concerns include care to decrease long-term surgical complications (especially after augmentation cystoplasty), to monitor for malignancy, to prepare for sex activity and fertility, and to help the adult patient in decision making. Transition aims to maximize quality of life and independence by ensuring uninterrupted appropriate care through a multidisciplinary approach which varies by geographical location and healthcare setting. Barriers include patient and family factors as well as provider and system related factors. A dedicated team is an important element of successful transition.
PURPOSE: Transition in urology is defined by the process that allows an adolescent or a young adult with a congenital or acquired urogenital anomaly to assume increasing responsibility for their own health care and to become the primary decision maker in their care. METHODS: A review of the literature regarding transitional care for lifelong urologic congenital anomalies was performed with the aim of reporting expert opinion when data are non-existent. This review focuses on special considerations for adolescents and young adults with spina bifida, bladder exstrophy, anorectal malformations and differences of sexual development. RESULTS: Urologic goals during the transition from childhood to adulthood continue to include attention to the preservation of renal function and optimization of lower urinary tract function. Additional concerns include care to decrease long-term surgical complications (especially after augmentation cystoplasty), to monitor for malignancy, to prepare for sex activity and fertility, and to help the adult patient in decision making. Transition aims to maximize quality of life and independence by ensuring uninterrupted appropriate care through a multidisciplinary approach which varies by geographical location and healthcare setting. Barriers include patient and family factors as well as provider and system related factors. A dedicated team is an important element of successful transition.
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