Transition and Lifelong Care in Congenital Urology (Current Clinical Urology)

Transitional Urology is designed to fill a critical gap that exists in the published literature by comprehensively addressing the urological challenges facing adolescents and adults with complex congenital anomalies of the genitourinary system. It provides a valuable resource to pediatricians and pediatric urologists facing urological management issues beyond their expertise in their aging patients as well as technical guidance to adult urologists who may have had little or no experience caring for patients with a congenital condition. This work will service as a field guide to congenitalism, providing a “how to” approach to guide the urologist using real clinical examples for the most common and challenging urological problems encountered. It also provides a framework for the transition process from pediatric to adult-centered care, with a special emphasis on the multidisciplinary nature needed to provide patient-centered care. Specific conditions that require special consideration, including myelomeningocele, exstrophy, posterior urethral valves, and hypospadias are highlighted. Topics considered common in the general urology practice- like infertility and sexual dysfunction are addressed within the context of patients with neurological or anatomical complexity. In addition, this text reviews urological complaints for which basic clinical algorithms are well-established within the context of a congenitally-abnormal bladder. Chapters discuss how and when special testing like video urodynamnics and positional fluoroscopy may be warranted to provide critical diagnostic guidance. The text also review how typical age-related urological phenomena, like elevated PSA, hypogonadism, and BPH, may present in this subset of patients and how treatment of these conditions may be different than the general population.​ Front Matter....Pages i-x Front Matter....Pages 1-1 The Transition Process: Initial Assessment and Development of a Treatment Plan....Pages 3-10 Approach to the Myelodysplasia Patient....Pages 11-26 Approach to the Exstrophy Patient....Pages 27-33 Approach to the Adult Hypospadias Patient....Pages 35-42 Front Matter....Pages 43-43 Sexual Function and Pregnancy in the Female Myelodysplasia Patient....Pages 45-54 Revision Genitoplasty, Sexual Function, Fertility, and Pelvic Organ Prolapse in Exstrophy and the Management of Pregnancy....Pages 55-64 Issues in the Long-Term Management of Adolescents and Adults with DSD: Management of Gonads, Genital Reconstruction, and Late Presentation of the Undiagnosed DSD....Pages 65-75 The Adult Hypospadias Patient: Technical Challenges in Adulthood....Pages 77-96 Front Matter....Pages 97-97 Urinary Tract Infections in the Reconstructed Bladder: Evaluation and Treatment Options....Pages 99-113 Troubleshooting Continent Catheterizable Channels....Pages 115-121 Augmentation Cystoplasty: Risks for Malignancy and Suggestions for Follow-Up Evaluations....Pages 123-130 BPH and Pelvic Organ Prolapse in Patients with Neurogenic Bladder....Pages 131-139 Posterior Urethral Valves in Adolescents: Clinical Problems, Management, and Follow-Up....Pages 141-145 Front Matter....Pages 147-147 Renal Transplantation in Patients with Lower Urinary Tract Dysfunction....Pages 149-162 Management of Calculi in Patients with Congenital Neuropathic Bladder....Pages 163-172 Vesicoureteral Reflux and the Adult....Pages 173-205 Front Matter....Pages 207-207 Adult Survivors of Pediatric Genitourinary Tumors....Pages 209-216 Back Matter....Pages 217-222 This volume will cover many of the most prevalent challenges for the urologist caring for adult congenital patients. The first section of the text will provide a framework for transition to an adult care model as well as a general approach to patients with three of the most common conditions encountered in congenitalism: myelodysplasia, Hypospadias, and exstrophy. The remainder of the text will cover anatomic issues in sexuality, fertitlity and genital issues, lower tract management, as well as upper tract management. Lastly, urological care of the pediatric cancer survivor will also be reviewed. Transition and Lifelong Care in Congenital Urology is a valuable guide for Urologists providing long term care and treatment to patients with congenital anomalies and urological age-related problems.