Navigating the waters of LUTS from childhood to puberty - NOPIA meeting (ICI-RS 2024).

Abstract

Introduction: Lower urinary tract symptoms (LUTS) are known to significantly affect health-related quality of life, often leading to psychological and social challenges. Despite the prevalence of paediatric and adult LUTS, the needs for, and the process of transition from childhood to adolescence and young adulthood remain both poorly understood or defined, with many patients lacking organized follow-up care.

Methods: This article summarizes discussions during an NOPIA Research Meeting following the International Consultation on Incontinence - Research Society (ICI-RS) 2024 on the topic of LUTS management practices in childhood and adolescence, and evaluates existing transition models in this population. Current gaps in research and clinical practice are highlighted, aiming to advance transitional care for persistent LUTS across age groups.

Results: Consensus acknowledged that maturation from childhood to adolescence significantly changes the urinary system, driven by hormonal shifts, lifestyle factors, and neuroendocrine development. Puberty-related hormone surges in both genders influence bladder growth and control, while lifestyle habits, affect kidney function and nocturnal urine production. Psychological factors and changes in sleep pattern, also play a crucial role. Prospective research has identified risk factors for adolescent LUTS persisting into adulthood, including childhood urinary incontinence trajectories, biopsychosocial influences and adverse childhood experiences (ACEs), all of which are also linked to mental health challenges in adolescence. Recent advances in adolescent LUTS treatment options are numerous but current literature lacks protocols and guidance for effective transitional care processes, to effectively manage the individuals' complex ongoing needs.

Conclusion: The persistence of childhood LUTS into adulthood requires an individualized, multidisciplinary approach and comprehensive transitional care system with management guidelines that need to be developed to ensure continuity of care through key developmental stages.