Metabolic and Electrolyte Abnormalities Related to Use of Bowel in Urologic Reconstruction.

Many urologic reconstructive techniques involve the use of autologous bowel for urinary diversion and bladder augmentation. The resection of bowel and its reimplantation into the urinary system often comes with a variety of metabolic and electrolyte derangements, depending on the type of bowel used and the quantity of urine it is exposed to in its final anatomic position. Clinicians should be aware of these potential complications due to the serious consequences that may result from uncorrected electrolyte disturbances. This article reviews the common electrolyte complications related to both bowel resection and the interposition of bowel within the urinary tract.

Transition of urologic patients from pediatric to adult care: a preliminary assessment of readiness in spina bifida patients.

OBJECTIVE: To assess the awareness and readiness of both spina bifida patients and parents regarding the transition process before transitioning, with a secondary aim that included identifying potential factors associated with successful transition. METHODS: All children aged ≥14 years requiring long-term care were prospectively enrolled. Questions designed by pediatric and adult urologists and an adolescent health specialist addressing the awareness of long-term follow-up and the desire to learn more about transitioning were administered by nursing staff at regularly scheduled clinic appointments. All spina bifida patients evaluated in the past 5 years were identified, and clinical factors associated with transitioning were compared. Statistical analysis using the Fisher exact test and the chi-square test were used to compare patients' and parents' responses and categorical variables between patients transitioned and those eligible. P <.05 was considered significant. RESULTS: A total of 33 surveys were prospectively collected. Twenty-two percent of parents and 40% of patients said they never wanted to transition (P = .28). Parents had thought about transitioning more than the patients (88.9% and 40%, respectively; P = .002). Of the 97 patients eligible for transition, 34% had a transition plan. The only significant predictor of transitioning to adult care was a previous history of stones (P = .03). CONCLUSION: Transitioning to adult urologic care is a necessity for many, and parents are significantly more aware of transitioning than the patient. Acknowledging and understanding the concerns of patients and families will help optimize the transition to adult urologic care.