From Cradle to College: Care of the Pediatric Patient with a Urinary Diversion From Infancy Through Adolescence

Infants with complex anomalies affecting continence can pose many challenges to the health care team. As these infants grow and progress through childhood and adolescence pose even greater challenges from both a developmental and physiologic standpoint. This session will explore the developmental, educational, medical, and surgical needs of the pediatric patient with a urinary diversion as they progress from infancy through adolescence. In addition to addressing developmental needs, discussion includes a review of various congenital and acquired conditions necessitating urinary and diversions. An overview of surgical procedures will be presented since a good understanding of the unique anatomy is crucial in planning care. A case scenario format will be used to describe patient approaches for a variety of conditions in five unique cases: bladder/cloacal exstrophy, spina bifida, and two oncologic conditions resulting in pelvic radiation sequelae. Proper transitioning through one phase of development to another is important and the wound, ostomy, continence nurse (WOCN) plays a vital role in creating smooth transitions. School, sports, body image, peer and partner concerns are addressed. Fostering adaptation through each stage of development is a focus of care. A review of a wide array of ostomy appliances and accessories, and tricks of the trade will also be presented.