Transition and Lifelong Care in Congenital Urology

Hadley M. Wood, MD, FACS Assistant Professor of Surgery Center for Genitourinary Reconstruction Glickman Urological and Kidney Institute Cleveland, OH

The basics.- The transition process: Initial assessment and defining goals and development of the multidisciplinary team.- Approach to the myelodysplasia patient.- Approach to the exstrophy patient.- Approach to the posterior urethral valve patient.- Approach to the hypospadias cripple.- Genital/urethra.- Sexual function/fertility in myelodysplasia.- Male (ejac/erectile).- Female (incl POP).- Revision genitoplasty, sexual function, fertility and pelvic organ prolapse in exstrophy + management of pregnancy.- Natural history of adults with hypospadias + urethral reconstruction, fertility, and chordee in hypospadias.- Issues in the long-term management of adolescents and adults with disorders of sexual differentiation (management of gonads, genital reconstruction, late presentation of the undiagnosed DSD).- Lower tract problems in adulthood for patients with bladder reconstructions.- New or escalating recurrent UTIsTBD.- Progressive renal deterioration - distinguishing urological from nephrological causes. Include nephrology input on renal protection.- New or worsening incontinence.- Trouble-shooting urostomies (leakage/stenosis) - indications for and approaches to revision surgery.- Cancer risk and surveillance in the patient with a augmentation cystoplasty or urostomy.- Upper tract considerations.- Renal transplant in patients with abnormal lower tracts.- Management of calculi in patients with malabsorption or osteodystrophy.- Late presentation of patient with primary bladder neck obstruction and/or PUV.- Age-related urological problems in the complex urological patient.- BPH and neurogenic bladder.- Prostate cancer screening/treatment.- Hypogonadism.- Urological follow-up of childhood malignancies eg Wilms Tumor and Rhabdomyoscarcomas.

"This volume ... is a comprehensive guide to the care of patients with congenital urologic diseases. ... helpful for pediatricians and general practitioners, as a multidisciplinary approach is typically needed for these complex patients. ... This is a unique book in the field of urology about the care of the adult patient who has a congenital urological condition. Many urologists are uncomfortable caring for these patients given their complex histories, but this book provides extensive information on their treatment." (Jennifer A. Hagerty, Doody's Book Reviews, July, 2015)