Urological Follow-up in Adult Spina Bifida Patients: Is There an Ideal Interval?

Duplisea, Jon; Romao, Rodrigo; MacLellan, Dawn L.; Cox, Ashley; Anderson, Peter

doi:10.1016/j.urology.2016.06.025

Cited by 11 publications

(5 citation statements)

References 7 publications

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“…Symptoms such as fever, malaise or increased incontinence merit early evaluation and culture to allow tailored antibiotic management. 51 Andrological and gynaecological care. It is completely normal for all adolescents to question themselves and others about sexual and reproductive function, and to seek clarification regarding the impact their condition and its treatment will have on this.…”

Section: Discussionmentioning

confidence: 99%

The transition of young adults with lifelong urological needs from pediatric to adult services: An international children's continence society position statement

Bower

Christie

DeGennaro

et al. 2016

Neurourology and Urodynamics

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Transitioning and transfer of children with major congenital anomalies to clinicians potentially unfamiliar with their conditions requires improved education both for receiving doctors and children's families. Early initiation of the transition process should allow the transference to take place at appropriate times based on the child's development, and environmental and financial factors. Neurourol. Urodynam. 36:811-819, 2017. © 2016 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 99%

The transition of young adults with lifelong urological needs from pediatric to adult services: An international children's continence society position statement

Bower

Christie

DeGennaro

et al. 2016

Neurourology and Urodynamics

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“…14 Other studies have also reported a higher proportion of females in adult SB clinics, although to a lesser degree than seen in this study. 5,15,16 The greater difference seen in this cohort may be due to the lack of a transitional care process, which may disproportionally effect men. This could indicate a need to more intentionally keep men engaged in their medical care during the transitional process and in adulthood.…”

Section: Discussionmentioning

confidence: 91%

Ambulatory Care Use among Patients with Spina Bifida: Change in Care from Childhood to Adulthood

et al. 2018

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Purpose We examined the ambulatory health care visit utilization of spina bifida children, adults who transitioned to adult care, and adults who continued to seek care in a pediatric setting. Methods We evaluated utilization over a one-year period for SB patients who visited any outpatient medical clinic within an integrated health care system. Patients were categorized as pediatric (<18) or adult (≥ 18). Adults were divided into those who did not fully transition to adult care (DNT) and patients who fully transitioned (adult). Frequency and type of health care utilization were compared. Sub-analysis was performed for patients aged 18–25 to examine variables associated with successful complete transition to adult care. Results Over one year, 382 children, 88 DNT, and 293 adult SB patients had 4,931 clinic visits. Children had greater ambulatory care utilization (7.25 visits/year) compared to fully transitioned adults (5.33 visits/year, p=0.046). Children more commonly visited surgery clinics (52.3% of visits) and adults more commonly visited medical clinics (48.9%) (p<0.005). Adult transitioned patients were more likely to be female (p=0.004). Of patients 18–25 years old, those who did not transition to adult care had similar outpatient visit types but higher utilization of inpatient and emergency care than those who transitioned. Conclusions SB children utilized more ambulatory care than adults and were more likely to visit a surgical specialist. Adult SB patients who successfully transitioned to adult care were more likely to be female and patients who failed to transition were more likely to have more inpatient and emergency care.

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“…as an alternative to repeat urodynamics. However, CT is commonly used in the neurourological management of spina bifida patients in the context of urinary tract infections or to detect urolithiasis [4,[19][20]. Abdominal CT are also frequently performed for other purposes in spina bifida patients, for instance for ventriculoperitoneal shunts issues [21].…”

Section: Discussionmentioning

confidence: 99%

Contrast-enhanced CT Texture Parameters as Predictive Markers of High-risk Urodynamic Features in Adult Patients with Spina Bifida

Khene

Richard

Hascoët

et al. 2019

Urology

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Objective to investigate computed tomography (CT) texture analysis of the bladder wall as a predictor of urodynamics findings in adult patient with spina bifida. Methods A single-center prospective trial was conducted from March 2015 to March 2017 including all consecutive adult spina bifida patients seen for urodynamic testing. A contrast-enhanced abdominal CT was systematically performed in all patients during the same visit. Texture features of the bladder wall related to the gray-level histogram and gray-level co-occurrence were evaluated on CT images. Multivariate analysis was performed to identify independent predictors of poor bladder compliance (PBC) and detrusor overactivity (DO) among clinical and texture parameters. Results Fourty patients were included. The Lasso penalized logistic regression analysis identified two texture parameters as potential predictors of poor bladder compliance: Skewness (coefficient weight,-1.81) and S.1.1.SumVarnc (coefficient weight,-3.52). Multivariate Logistic regression analysis confirmed skewness (OR (CI 95%) = 0.40 (0.14, 0.97), p = 0.04) as an independent predictor of PBC. The Lasso penalized logistic regression analysis identified one texture parameters as potential predictor of DO: Kurtosis (coefficient weight,-3.52). which was confirmed in multivariate logistic regression analysis (OR (CI 95%) = 1.12 (1.01, 1.55), p = 0.02. Conclusion Our findings demonstrate that CT texture analysis of the bladder wall might be an interesting tool to identify spina bifida patients with high risk urodynamic features.

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Urological Follow-up in Adult Spina Bifida Patients: Is There an Ideal Interval?

Cited by 11 publications

References 7 publications

The transition of young adults with lifelong urological needs from pediatric to adult services: An international children's continence society position statement

The transition of young adults with lifelong urological needs from pediatric to adult services: An international children's continence society position statement

Ambulatory Care Use among Patients with Spina Bifida: Change in Care from Childhood to Adulthood

Contrast-enhanced CT Texture Parameters as Predictive Markers of High-risk Urodynamic Features in Adult Patients with Spina Bifida

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