It is known that transition from pediatric to adult urologic care is difficult in many different groups of patients, but more so in the spina bifida (SB) patient. It has been estimated that up to two-thirds of adult SB patients do not have regular follow up, however, they tend to have active urologic problems including urolithiasis, renal insufficiencies, and chronic urinary tract infections.
This presentation looked at the transition of SB patients so as to identify their needs. Retrospectively reviewed patients with SB transitioning to urology clinic from 2012 to 2015. A total of 38 patients met this criteria, 22 females and 16 males, mean age was 22.6 years, range was 17.5 to 61.4. 63% of these patients had a history of reconstruction consisting of bladder augmentation with continent catheterizable stoma. 53% managed their bladder through a continent catheterizable stoma, 39% used urethral clean intermittent catheterization and 5% had a Foley catheter. Only 1 out of 38 patients had a suprapubic catheter and 1 had an iliel conduit. Of 21 patients, 55%, had an antegrade continence enema (ACE) while 2 or 5% had colostomy and the remaining 15 did other by programs. At the time of the presentation, 28 patients had a total of 50 urological issues including urinary tract infection, urinary incontinence, bladder calculi, nephrolithiasis and issues with catheterizing their continent stoma. There was a need for urodynamic studies, surgical intervention as well as diagnostic intervention. These authors felt that urologic problems are high at presentation to transition to a urology clinic and really reinforced the fact that these patients need urologic care into adulthood and need to be followed closely.
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Presented by: McCabe C et al. at 2016 AUA Annual Meeting - May 6 - 10, 2016 – San Diego, California, USA
Diane K. Newman, DNP, Adjunct Professor of Urology in Surgery, Research Investigator Senior and Co-Director, Penn Center for Continence and Pelvic Health
University of Pennsylvania, Division of Urology, 3400 Spruce Street, 3rd Floor Perelman Bldg, Philadelphia, PA. 19104