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De l’urologie pédiatrique à l’urologie adulte, quelle prise en charge de l’adolescent ? État des lieux d’une consultation de transition en urologie
- Source :
- Progrès en Urologie, Progrès en Urologie, Elsevier Masson, 2017, 27 (12), pp.647-653. ⟨10.1016/j.purol.2017.05.010⟩
- Publication Year :
- 2017
- Publisher :
- Elsevier BV, 2017.
-
Abstract
- To provide an adequate lifelong urological care in the complex period of adolescence, a transition consultation conducted by a paediatric surgeon and an urologist was developed in our institution. As a real rite of passage, it allows the follow-up and the adapted care of urological conditions, sometimes complex, and permits the transition between childhood and the world of grown-ups. We reported our experience at the Children Hospital of our institution (paediatric surgery and urology departments). During a 6 months period (January-July 2015), forty-five young adults with a mean age of 17.8±3.6 years were seen in transition consultation. Eight patients had neurogenic voiding disorders (4 spina bifida, 1 multiple sclerosis, 1 mitochondrial encephalopathy, 1 metachromic leucodystrophy, 1 paraplegia), 9 patients had idiopathic voiding disorders, 1 patient had a non obstructive malformative uropathy; and 30 patients had surgery during infancy and childhood: hypospadias in 17 young men and malformative uropathy in 13 patients. This consultation occurred within 4.6±4.5 years after the last consultation with paediatric surgeon. For 6 patients, the transition consultation was the first for the urological problem. After this consultation, 8 patients stayed in paediatric surgery and 37 patients were referred to adult urologist. Among those 8 patients: 2 patients had cognitive and psychiatric disorders; 4 patients refused to be transferred to adult unit; 2 patients wanted to come back at transition consultation. Among the 37 patients transferred in adult urological care: 6 patients had urological surgery, and one patient was referred to a sexology consultation. The remaining 30 patients have initiated long-term monitoring. All reconvened patients came back at the follow-up visit (at least 12 months follow-up). A 16-year-old patient (spina bifida with polymalformative syndrome) developed a depressive syndrome at the end of the consultation, in the motive of an awareness of the definitive nature of his handicap and the need of medical follow-up throughout his life. Transition consultation makes easier the passage from paediatric care to adult urological care. It allows a smooth change of interlocutors, facilitates subsequent care and improves compliance to medical follow-up. It requires a good collaboration between paediatric and adult care units. Transition responds to an increasing request of adolescents, families, and medical teams, since care rupture during adolescence can have functional and psychological consequences. Level of proof 4.
- Subjects :
- medicine.medical_specialty
Uropathy
Sexology
Spina bifida
business.industry
[SDV]Life Sciences [q-bio]
Urology
General surgery
030232 urology & nephrology
medicine.disease
3. Good health
03 medical and health sciences
0302 clinical medicine
Hypospadias
030220 oncology & carcinogenesis
medicine
Transitional care
Young adult
Paraplegia
business
ComputingMilieux_MISCELLANEOUS
Voiding Disorders
Subjects
Details
- ISSN :
- 11667087 and 24055131
- Volume :
- 27
- Database :
- OpenAIRE
- Journal :
- Progrès en Urologie
- Accession number :
- edsair.doi.dedup.....22f4ec682bd1a33724a490dabb4d0149