Affiliation:
1. Department of Internal Medicine and Pediatrics Ghent University Ghent Belgium
2. Department of Pediatric Intensive Care Brussels University Hospital Brussels Belgium
3. Department of Urology, eUROGEN Accredited Center Ghent University Hospital Ghent Belgium
4. Department of Pediatric Nephrology Ghent University Hospital Ghent Belgium
5. Department of Child & Adolescent Psychiatry, Pediatric Sleep Center Ghent University Hospital Ghent Belgium
6. Department of Rehabilitation Sciences Ghent University Ghent Belgium
Abstract
AbstractBackgroundNocturnal 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 & MethodsTo 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).ResultsThese 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%).DiscussionWe 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.