Transition to adulthood after childhood cystoplasty: Patient perspectives

Augmentation cystoplasty (AC) is indicated for the management of congenital bladder dysfunction when conservative medical treatments have failed. This procedure can have significant consequences on patients' lives, requiring long-term care, particularly during the transition to adulthood. This study evaluates the reported experiences of patients who underwent augmentation cystoplasty during childhood or adolescence, with a focus on transitional care and long-term satisfaction.

A retrospective chart review of patients who underwent an augmentation cystoplasty with an intestinal patch for congenital bladder dysfunction between 1990 and 2017 was performed. A questionnaire-based analysis was designed to assess adult patients' satisfaction and experiences. Statistical correlation analysis using the Pearson correlation coefficient was performed between the variables considered.

Of 33 patients, 17 consented to participate in the survey. Follow-up ranged from 10 to 26 years. Participants included 9 male and 8 female patients, aged 19-44 years, with a mean BMI of 24.9kg/m². Daily self-catheterization frequency was the best predictor of patient satisfaction during the transition to adulthood (P=0.0004). Patients continuing follow-up at the same institution reported greater satisfaction, though this was not statistically significant (P=0.4140).

Lifelong follow-up after augmentation cystoplasty is essential for long-term success. Patients who remain with the same healthcare team tend to gain confidence, leading to improved compliance, fewer complications, and greater overall satisfaction. Promoting continuity of care and better educating adult urologists about the needs of these patients are essential to optimize outcomes.

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