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Updated: Jul 22, 2025
Surgical Management of Meatal Stenosis with Meatoplasty
Published on: November 30, 2010
Long-term risks of childhood surgery
Gunter De Win1, Laetitia De Kort2, Hazel Learner3
1University Hospital Antwerp, Department of Urology, Edegem, Belgium; ASTARC, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Adolescent & Congenital Lifelong Urology, University College London Hospitals, London, UK.
Insights
Adults who had pediatric urological surgery face long-term issues like infections and kidney problems. Lifelong monitoring in specialized centers is crucial for managing these late complications.
Area of Science:
- Pediatric Urology
- Adult Urology
- Congenital Anomalies
Background:
- Major reconstructive pediatric urological surgery can lead to long-term complications in adulthood.
- Lifelong follow-up is essential for patients with congenital urological conditions.
Purpose of the Study:
- To provide an overview of the long-term consequences of childhood urological surgery.
- To outline management strategies for late-onset complications.
Main Methods:
- Consensus process involving experienced pediatric urologists.
- Literature review and expert commentary on complications of childhood urological surgery.
Main Results:
- Common long-term issues include renal impairment, metabolic disturbances, bladder stones, Vitamin B12 deficiency, and recurrent infections.
- Challenges in management involve ureteric strictures, catheterizable channel issues (obstruction/incontinence), female sexuality, pregnancy, and secondary malignancies.
Conclusions:
- Management of rare congenital conditions requires specialized, lifelong follow-up.
- Revisional surgery for these conditions is complex and necessitates care in specialized centers.
Introduction:
Several patients, who underwent major reconstruction under the care of an experienced pediatric urologist are now, as adults, several years later, appearing with long term problems and complications. This consensus process was undertaken to give an overview of long term consequences (and their management) of urological childhood surgery.
Material And Methods:
Several known urologists with experience in life-long follow up and revisional surgery of patients with congenital conditions were asked to review literature and comment based on their experience about several complications of childhood surgery.
Results:
Renal impairment, metabolic consequences, bladder stones, Vit B 12 deficiency and recurrent infections are often encountered. Also recurrent ureteric strictures and difficulties with catheterizable channel (both obstruction and incontinence) can be challenging to manage. Specific attention is needed regarding female sexuality and pregnancy. Both the development of malignancies in reconstructed bladders as secondary malignancies need to be taken into account during follow up.
Conclusion:
Follow up of patients with rare congenital conditions is highly specialized and revisional surgery can be challenging. Therefore, follow up needs to be organized in specialized centers.
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