Kyle A Scarberry1,2,3, Ronak A Gor4,5, Robert C Kovell6,7. 1. Urology Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA. kylescarberry1@gmail.com. 2. Department of Pediatric Urology, Rainbow Babies and Children's Hospital, Cleveland, OH, USA. kylescarberry1@gmail.com. 3. Case Western Reserve University School of Medicine, Cleveland, OH, USA. kylescarberry1@gmail.com. 4. Division of Urology, Cooper University Hospital, Camden, NJ, USA. 5. Cooper Medical School of Rowan University, Camden, NJ, USA. 6. Division of Urology, University of Pennsylvania Health System, West Philadelphia, PA, USA. 7. Division of Urology, Children's Hospitals of Philadelphia, West Philadelphia, PA, USA.
Abstract
PURPOSE OF REVIEW: Patients with congenital urologic conditions present unique challenges as adults. Herein, we review the literature relevant to the adult reconstructive urologist confronted with complex surgical concerns affecting their patients with a history of hypospadias, spina bifida, and other syndromes affecting the genitourinary tract. RECENT FINDINGS: Urethral stricture disease related to hypospadias is complex, but successful urethroplasty and penile curvature correction can be achieved with an anatomically minded approach. Multiple urinary diversion techniques can be considered in a patient-centered approach to bladder management in the adult spina bifida patient, but complications are common and revision surgeries are frequently required. Strong evidence is lacking for most surgical techniques in this population, but experiences reported by pediatric and adult urologists with genitourinary reconstruction training can help foster consensus in decision-making. Urologists trained in genitourinary reconstruction may be uniquely positioned to care for the transitional urology patient as they enter adolescence and adulthood.
PURPOSE OF REVIEW: Patients with congenital urologic conditions present unique challenges as adults. Herein, we review the literature relevant to the adult reconstructive urologist confronted with complex surgical concerns affecting their patients with a history of hypospadias, spina bifida, and other syndromes affecting the genitourinary tract. RECENT FINDINGS: Urethral stricture disease related to hypospadias is complex, but successful urethroplasty and penile curvature correction can be achieved with an anatomically minded approach. Multiple urinary diversion techniques can be considered in a patient-centered approach to bladder management in the adult spina bifida patient, but complications are common and revision surgeries are frequently required. Strong evidence is lacking for most surgical techniques in this population, but experiences reported by pediatric and adult urologists with genitourinary reconstruction training can help foster consensus in decision-making. Urologists trained in genitourinary reconstruction may be uniquely positioned to care for the transitional urology patient as they enter adolescence and adulthood.
Authors: Betsy Hopson; Brandon G Rocque; David B Joseph; Danielle Powell; Amie B Jackson McLain; Richard D Davis; Tracey S Wilson; Michael J Conklin; Jeffrey P Blount Journal: J Pediatr Rehabil Med Date: 2018