Age-related urologic problems in the complex urologic patient.

Area of Science:

• Urology
• Adult Congenital Urology
• Lifelong Urology

Background:

• Improved pediatric care allows individuals with complex urological abnormalities to reach adulthood.
• These patients are now susceptible to common, age-related urological conditions.
• There is a need for guidance on managing adult urological issues in this population.

Purpose of the Study:

• To review existing data on age-related urological conditions in adults with congenital abnormalities.
• To provide recommendations where expert opinion is currently lacking.
• To address the unique needs of lifelong urology care.

Main Methods:

• Joint Société Internationale d'Urologie (SIU) and International Consultation on Urological Disease (ICUD) consultation.
• Analysis of data presented at the 2018 SIU annual conference.
• Expert review and consensus building.

Main Results:

• Benign prostatic hyperplasia (BPH) presentation may differ in neurogenic bladder patients, requiring thorough assessment.
• Prostate-specific antigen (PSA) screening and advanced imaging (multi-parametric MRI, transperineal biopsy) are recommended for eligible men.
• Bladder cancer in this group often presents later with a poorer prognosis.
• Parenthood is often achievable with assistance; pregnant women with prior reconstructive surgery need specialized obstetric and urological care.

Conclusions:

• Current evidence for complex urogenital abnormalities primarily derives from pediatric studies.
• Data on age-related urological issues often comes from the general adult population.
• Longitudinal data will increase as patients with congenital urological conditions live longer, aiding assessment of interventions.