Transition in enuresis patients: Identifying the gaps and opportunities for the future.

LUTS adolescence enuresis multidisciplinary team nocturia transition

Journal

Neurourology and urodynamics
ISSN: 1520-6777
Titre abrégé: Neurourol Urodyn
Pays: United States
ID NLM: 8303326

Informations de publication

Date de publication:
08 Apr 2024
Historique:
revised: 21 02 2024
received: 27 10 2023
accepted: 25 03 2024
medline: 8 4 2024
pubmed: 8 4 2024
entrez: 8 4 2024
Statut: aheadofprint

Résumé

Nocturnal enuresis is generally considered a children's condition, yet it may persist 1%-2% in adolescence and early adulthood. Refractory patients often demand follow-up by multidisciplinary teams, which is only restricted to some of the expert tertiary centers. However, there are no standardized transition programs/guidelines when follow-up must be passed from pediatric to adult healthcare providers. To investigate this issue, we conducted a literature search on enuresis transition, which resulted in no articles. We, therefore, proceeded in a rescue search strategy: we explored papers on transition programs of conditions that may be related and/or complicated by enuresis, nocturia, or other urinary symptoms (chronic diseases, CKD, bladder dysfunction, kidney transplant, neurogenic bladder). These programs emphasize the need for a multidisciplinary approach, a transition coordinator, and the importance of patient and parent participation, practices that could be adopted in enuresis. The lack of continuity in enuresis follow-up was highlighted when we investigated who was conducting research and publishing on enuresis and nocturia. Pediatric disciplines (50%) are mostly involved in children's studies, and urologists in the adult ones (37%). We propose a stepwise approach for the transition of children with enuresis from pediatric to adult care, depending on the clinical subtype: from refractory patients who demand more complex, multidisciplinary care and would benefit from a transition coordinator up to children/young adults cured of enuresis but who persist in having or present lower urinary tract symptoms (LUTS)/nocturia later on. In any case, the transition process should be initiated early at the age of 12-14 years, with adequate information to the patient and parents regarding relapses or LUTS/nocturia occurrence and of the future treating general practitioner on the enuresis characteristics and comorbidities of the patient.

Sections du résumé

BACKGROUND BACKGROUND
Nocturnal enuresis is generally considered a children's condition, yet it may persist 1%-2% in adolescence and early adulthood. Refractory patients often demand follow-up by multidisciplinary teams, which is only restricted to some of the expert tertiary centers. However, there are no standardized transition programs/guidelines when follow-up must be passed from pediatric to adult healthcare providers.
AIM, MATERIALS & METHODS UNASSIGNED
To investigate this issue, we conducted a literature search on enuresis transition, which resulted in no articles. We, therefore, proceeded in a rescue search strategy: we explored papers on transition programs of conditions that may be related and/or complicated by enuresis, nocturia, or other urinary symptoms (chronic diseases, CKD, bladder dysfunction, kidney transplant, neurogenic bladder).
RESULTS RESULTS
These programs emphasize the need for a multidisciplinary approach, a transition coordinator, and the importance of patient and parent participation, practices that could be adopted in enuresis. The lack of continuity in enuresis follow-up was highlighted when we investigated who was conducting research and publishing on enuresis and nocturia. Pediatric disciplines (50%) are mostly involved in children's studies, and urologists in the adult ones (37%).
DISCUSSION CONCLUSIONS
We propose a stepwise approach for the transition of children with enuresis from pediatric to adult care, depending on the clinical subtype: from refractory patients who demand more complex, multidisciplinary care and would benefit from a transition coordinator up to children/young adults cured of enuresis but who persist in having or present lower urinary tract symptoms (LUTS)/nocturia later on. In any case, the transition process should be initiated early at the age of 12-14 years, with adequate information to the patient and parents regarding relapses or LUTS/nocturia occurrence and of the future treating general practitioner on the enuresis characteristics and comorbidities of the patient.

Identifiants

pubmed: 38587243
doi: 10.1002/nau.25460
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024 Wiley Periodicals LLC.

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Auteurs

Sevasti Karamaria (S)

Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium.

Reiner Mauel (R)

Department of Pediatric Intensive Care, Brussels University Hospital, Brussels, Belgium.

Mauro Van den Ende (M)

Department of Urology, eUROGEN Accredited Center, Ghent University Hospital, Ghent, Belgium.

Ase Oosterlinck (A)

Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium.

Alice Verheye (A)

Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium.

Elke De Bruyne (E)

Department of Pediatric Nephrology, Ghent University Hospital, Ghent, Belgium.

Eva Degrauewe (E)

Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium.

Karlien Dhondt (K)

Department of Child & Adolescent Psychiatry, Pediatric Sleep Center, Ghent University Hospital, Ghent, Belgium.

Lien Dossche (L)

Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium.
Department of Pediatric Nephrology, Ghent University Hospital, Ghent, Belgium.

Ann Raes (A)

Department of Pediatric Nephrology, Ghent University Hospital, Ghent, Belgium.

Catherine Renson (C)

Department of Urology, eUROGEN Accredited Center, Ghent University Hospital, Ghent, Belgium.

Bieke Samijn (B)

Department of Urology, eUROGEN Accredited Center, Ghent University Hospital, Ghent, Belgium.
Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.

Anne-Francoise Spinoit (AF)

Department of Urology, eUROGEN Accredited Center, Ghent University Hospital, Ghent, Belgium.

Karel Everaert (K)

Department of Urology, eUROGEN Accredited Center, Ghent University Hospital, Ghent, Belgium.

Johan Vande Walle (JV)

Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium.

Classifications MeSH