Palliative Care for Pediatric Urology
Oscar Li1, Royce Lee1, Renee D Boss2
1Johns Hopkins University School of Medicine (O.L., R.L.), Baltimore, Maryland, USA.
Insights
Palliative care is underutilized in pediatric urology, despite its benefits for children with urologic conditions. Integrating palliative care teams can improve quality of life for these patients and their families.
Area of Science:
- Pediatric Urology
- Palliative Care
- Quality of Life
Background:
- Palliative care integration in adult urology is limited, and even less explored in pediatric urology.
- Pediatric urology patients often face life-limiting conditions requiring specialized care.
- Existing literature supports palliative care's benefits, yet its application in pediatric urology is minimal.
Purpose of the Study:
- To highlight the need for palliative care in pediatric urology.
- To identify specific pediatric urologic conditions that can benefit from palliative care.
- To emphasize palliative care's role in improving patient and family quality of life.
Main Methods:
- Literature review on palliative care in pediatric urology.
- Identification of key pediatric urologic conditions and their challenges.
- Discussion of palliative care's role in addressing physical and psychosocial symptoms.
Main Results:
- Palliative care can address complex challenges in pediatric urologic conditions like congenital lower urinary tract obstruction and neurogenic bladder.
- Palliative care teams can assist with decision-making, symptom management, and psychosocial support.
- Integration of palliative care alongside urologic interventions enhances patient and family well-being.
Conclusions:
- Palliative care is essential for pediatric urology patients with life-limiting conditions.
- Early integration of palliative care improves management of physical and psychosocial symptoms.
- Palliative care enhances the overall quality of life for pediatric urology patients and their families.
Abstract:
Palliative care in the field of urology has largely been limited to adult oncologic conditions. Although there is a plethora of established literature suggesting the advantageous impact of palliative care, there is limited integration of palliative care in adult urology. This underutilization is further exacerbated in pediatric urology, and palliative care in pediatric urology remains an underexplored area despite the prevalence of several life-limiting conditions in this patient population. This paper highlights the potential need for palliative care intervention in a variety of urologic conditions in the pediatric population, including congenital lower urinary tract obstruction, neurogenic bladder dysfunction, exstrophy-epispadias complex, and congenital bilateral renal agenesis. Each condition poses unique challenges that can be addressed with the inclusion of a palliative care team, including decision-making spanning prenatal-neonatal-pediatric periods, acute and chronic symptom management, family relations, body image issues, risk of recurrent hospitalizations and surgeries, and potentially fatal complications. Alongside standard urologic interventions, palliative care can serve as an additional means of addressing physical and psychosocial symptoms experienced by pediatric urology patients to enhance the quality of life of patients and their families.
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