Abstract：
OBJECTIVE: To evaluate the demographic and clinical characteristics of patients who visited our transitional urology (TU) outpatient clinic formed by pediatric urologists with urology background within the first year upon its establishment.
METHODS: Files of 130 consecutive patients who visited our TU outpatient clinic, which was established in 01 March 2021, between 01 March 2021 and 01 March 2022 were retrospectively collected. Patients were divided into two groups: those with a previous follow-up in our pediatric urology department (Group I, n: 81, 62.3%) and those who were followed up in other clinics during childhood (Group II, n: 49, 37.7%) afterwards. Demographic characteristics, complaints at admission, previous medical history, and management plans at the recent clinical visit were noted. We defined a successful and smooth transition from childhood to adult care as not being without follow-up within the first year after the age of 18 years and not requiring extraordinary medical assistance (e.g., emergency room visits, hospitalization, intensive care unit admissions) from the last urological control to the TU outpatient clinic visits.
RESULTS: The most common diagnoses were vesicoureteral reflux (n: 32, 24.6%), neuropathic bladder accompanied by spina bifida (n: 31, 23.8%), obstructive uropathy (n: 25, 19.2%), hypospadias (n: 20, 15.3%), non-neurogenic lower urinary tract dysfunction (n: 19, 14.6%), and bladder exstrophy (n: 8, 6.1%). The distribution of primary diagnosis in the two patient groups was similar. The median time from the last pediatric urology visit to the current TU clinical visit was significantly longer in Group II (12 vs. 60 months, p < 0.001),consequently, the median patient age at admission was significantly higher in Group II (21 vs. 23 years, p = 0.020). The rate of a successful and smooth transition was 86.4% in Group I, whereas Group II had a completely unsuccessful transition period. Upon admission to TU outpatient clinic, the requirement of a surgical intervention was lower in Group I (21% vs. 38.8%, p = 0.028).Also,the need for medical treatment changes was higher in Group II (9.9% vs. 53.1%, p < 0.001).
CONCLUSIONS: Our findings emphasize the importance of patient referral to a TU clinic that deal with lifelong problems of congenital genitourinary diseases. Delays in receiving medical or surgical treatments during transition from childhood to adulthood may be associated with higher need for subsequent surgical interventions in this vulnerable patient population.
METHODS: Files of 130 consecutive patients who visited our TU outpatient clinic, which was established in 01 March 2021, between 01 March 2021 and 01 March 2022 were retrospectively collected. Patients were divided into two groups: those with a previous follow-up in our pediatric urology department (Group I, n: 81, 62.3%) and those who were followed up in other clinics during childhood (Group II, n: 49, 37.7%) afterwards. Demographic characteristics, complaints at admission, previous medical history, and management plans at the recent clinical visit were noted. We defined a successful and smooth transition from childhood to adult care as not being without follow-up within the first year after the age of 18 years and not requiring extraordinary medical assistance (e.g., emergency room visits, hospitalization, intensive care unit admissions) from the last urological control to the TU outpatient clinic visits.
RESULTS: The most common diagnoses were vesicoureteral reflux (n: 32, 24.6%), neuropathic bladder accompanied by spina bifida (n: 31, 23.8%), obstructive uropathy (n: 25, 19.2%), hypospadias (n: 20, 15.3%), non-neurogenic lower urinary tract dysfunction (n: 19, 14.6%), and bladder exstrophy (n: 8, 6.1%). The distribution of primary diagnosis in the two patient groups was similar. The median time from the last pediatric urology visit to the current TU clinical visit was significantly longer in Group II (12 vs. 60 months, p < 0.001),consequently, the median patient age at admission was significantly higher in Group II (21 vs. 23 years, p = 0.020). The rate of a successful and smooth transition was 86.4% in Group I, whereas Group II had a completely unsuccessful transition period. Upon admission to TU outpatient clinic, the requirement of a surgical intervention was lower in Group I (21% vs. 38.8%, p = 0.028).Also,the need for medical treatment changes was higher in Group II (9.9% vs. 53.1%, p < 0.001).
CONCLUSIONS: Our findings emphasize the importance of patient referral to a TU clinic that deal with lifelong problems of congenital genitourinary diseases. Delays in receiving medical or surgical treatments during transition from childhood to adulthood may be associated with higher need for subsequent surgical interventions in this vulnerable patient population.
摘要：
目的：评估由具有泌尿外科背景的儿科泌尿科医师在成立后的第一年内访问我们的过渡泌尿外科（TU）门诊的患者的人口统计学和临床特征。
方法：访问我们TU门诊的130名连续患者的文件，它成立于2021年3月1日，2021年3月1日至2022年3月1日之间是回顾性收集的。患者分为两组：在我们的儿科泌尿科进行过随访的患者（第一组，n：81，62.3％）和儿童时期在其他诊所接受随访的人（第二组，n：49，37.7%）之后。人口特征，入院时的投诉，既往病史,并记录了近期临床访视时的管理计划.我们将从儿童护理到成人护理的成功和平稳过渡定义为在18岁后的第一年内没有随访，并且不需要特别的医疗援助（例如，急诊室探视,住院治疗,重症监护病房入院）从上次泌尿外科控制到TU门诊就诊。
结果：最常见的诊断是膀胱输尿管反流（n：32，24.6%），神经性膀胱伴脊柱裂（n：31，23.8%），梗阻性尿路病（n：25，19.2%），尿道下裂(n:20,15.3%),非神经源性下尿路功能障碍（n：19，14.6％），和膀胱外翻（n：8，6.1％）。两组患者的主要诊断分布相似。在II组中，从上次儿科泌尿科就诊到当前TU临床就诊的中位时间明显更长（12vs.60个月,p<0.001)，因此,II组患者入院时的中位年龄显著较高(21vs.23年,p=0.020)。第一组成功平稳过渡率为86.4%,而第二组有一个完全不成功的过渡期。入住TU门诊诊所后，第一组的手术干预要求较低(21%vs.38.8%,p=0.028)。此外，第二组对医疗变化的需求更高(9.9%与53.1%,p<0.001)。
结论：我们的研究结果强调了患者转诊到处理先天性泌尿生殖系统疾病终生问题的TU诊所的重要性。在从儿童到成年的过渡期间，接受药物或手术治疗的延迟可能与该脆弱患者群体对后续手术干预的更高需求有关。
方法：访问我们TU门诊的130名连续患者的文件，它成立于2021年3月1日，2021年3月1日至2022年3月1日之间是回顾性收集的。患者分为两组：在我们的儿科泌尿科进行过随访的患者（第一组，n：81，62.3％）和儿童时期在其他诊所接受随访的人（第二组，n：49，37.7%）之后。人口特征，入院时的投诉，既往病史,并记录了近期临床访视时的管理计划.我们将从儿童护理到成人护理的成功和平稳过渡定义为在18岁后的第一年内没有随访，并且不需要特别的医疗援助（例如，急诊室探视,住院治疗,重症监护病房入院）从上次泌尿外科控制到TU门诊就诊。
结果：最常见的诊断是膀胱输尿管反流（n：32，24.6%），神经性膀胱伴脊柱裂（n：31，23.8%），梗阻性尿路病（n：25，19.2%），尿道下裂(n:20,15.3%),非神经源性下尿路功能障碍（n：19，14.6％），和膀胱外翻（n：8，6.1％）。两组患者的主要诊断分布相似。在II组中，从上次儿科泌尿科就诊到当前TU临床就诊的中位时间明显更长（12vs.60个月,p<0.001)，因此,II组患者入院时的中位年龄显著较高(21vs.23年,p=0.020)。第一组成功平稳过渡率为86.4%,而第二组有一个完全不成功的过渡期。入住TU门诊诊所后，第一组的手术干预要求较低(21%vs.38.8%,p=0.028)。此外，第二组对医疗变化的需求更高(9.9%与53.1%,p<0.001)。
结论：我们的研究结果强调了患者转诊到处理先天性泌尿生殖系统疾病终生问题的TU诊所的重要性。在从儿童到成年的过渡期间，接受药物或手术治疗的延迟可能与该脆弱患者群体对后续手术干预的更高需求有关。
