We have seen a 27 year old patient. She came to us with a vestibular fistula, which was repaired as a newborn, and uh she had been suffering from incontinent stool uh situations uh all the time after the surgery, but uh she was told that this was quite fine and normal and there was no way to optimize the situation.
We have seen a 27 year old patient. She came to us with a vestibular fistula, which was repaired as a newborn, and uh she had been suffering from incontinent stool uh situations uh all the time after the surgery, but uh she was told that this was quite fine and normal and there was no way to optimize the situation.
what we do is when we see them annually, we try to organize that the adult surgeon is present as well, so he gets to know the patient. And the patient gets to know the adult surgeon because usually they have another way of treating patients and This is something that the patient has to learn from the adult surgeon
what we do is when we see them annually, we try to organize that the adult surgeon is present as well, so he gets to know the patient. And the patient gets to know the adult surgeon because usually they have another way of treating patients and This is something that the patient has to learn from the adult surgeon
Colorectal Quiz Episode 38: Transitional Care in Colorectal Surgery
▶Ep 49 · 1:25
quoteWe have seen a 27 year old patient. She came to us with a vestibular fistula, which was repaired as a newborn, and uh she had been suffering from incontinent stool uh situations uh all the time after the surgery, but uh she was told that this was quite fine and normal and there was no way to optimize the situation.↗
▶Ep 49 · 1:25
clinicalA 27-year-old female presented with lifelong fecal incontinence following newborn repair of rectal vestibular fistula; she had been told her incontinence was normal and unavoidable until puberty when daily irrigations were introduced, which restored her social life.↗
▶Ep 49 · 1:54
quoteThen when she went into puberty, she was told that there was a possibility to do daily irrigations, and she did that and uh with this she was, she gained social a social life back again, how she told us.↗
▶Ep 49 · 2:22
clinicalThe patient had rectal prolapse 2–3 years prior to presentation, which was repaired by an adult colorectal surgeon.↗
▶Ep 49 · 2:45
clinicalOriginal operation reports from the early 1990s were incomplete, making it difficult to evaluate the initial surgical situation.↗
▶Ep 49 · 6:42
clinicalExamination under anesthesia with electrical stimulation and anal ultrasound confirmed a C-shaped sphincter with the anterior part not surrounded by sphincter muscle.↗
▶Ep 49 · 7:12
clinicalThe rectal prolapse treated by the adult surgeon (mucosal plication) was interpreted as a late sign of the missing sphincter complex.↗
▶Ep 49 · 12:00
guidelineIn Germany, pediatric surgeons are not allowed to treat patients over age 18, necessitating transition to adult care.↗
▶Ep 49 · 12:00
clinicalThe German transition model begins at age 12 by informing parents that the patient cannot stay in pediatric surgery forever; a network is built with adult colorectal surgeons interested in pediatric procedures, and connections are made to adult physiotherapists, urologists, and gynecologists.↗
▶Ep 49 · 12:00
quoteIt depends, of course, on each patient, how is his ability to think about his own situation, their interests, and usually we do it like this, that at the age of 12 we talk to the parents that they cannot stay forever in the peat surgery department.↗
▶Ep 49 · 12:20
quoteWe are not allowed to treat over the age of 18 here in Germany, so we try to get them connected to adult colorectal surgeons.↗
▶Ep 49 · 13:04
quotewhat we do is when we see them annually, we try to organize that the adult surgeon is present as well, so he gets to know the patient. And the patient gets to know the adult surgeon because usually they have another way of treating patients and This is something that the patient has to learn from the adult surgeon↗
▶Ep 49 · 13:04
clinicalDuring annual visits, the adult surgeon is present so both patient and surgeon get to know each other; the adult surgeon learns the patient's past medical history and the pediatric surgeon explains procedures. This 'soft transition' lasts 3–4 years with the goal that the patient eventually sees only the adult colorectal surgeon.↗
Colorectal Quiz Episode 38: Transitional Care in Colorectal Surgery
▶Ep 158 · 1:25
quoteWe have seen a 27 year old patient. She came to us with a vestibular fistula, which was repaired as a newborn, and uh she had been suffering from incontinent stool uh situations uh all the time after the surgery, but uh she was told that this was quite fine and normal and there was no way to optimize the situation.↗
▶Ep 158 · 1:25
clinicalA 27-year-old female presented with lifelong fecal incontinence following newborn repair of rectal vestibular fistula; she had been told her incontinence was normal and unavoidable until puberty when daily irrigations were introduced, which restored her social life.↗
▶Ep 158 · 1:54
quoteThen when she went into puberty, she was told that there was a possibility to do daily irrigations, and she did that and uh with this she was, she gained social a social life back again, how she told us.↗
▶Ep 158 · 2:22
clinicalThe patient had rectal prolapse 2–3 years prior to presentation, which was repaired by an adult colorectal surgeon.↗
▶Ep 158 · 2:45
clinicalOriginal operation reports from the early 1990s were incomplete, making it difficult to evaluate the initial surgical situation.↗
▶Ep 158 · 6:42
clinicalExamination under anesthesia with electrical stimulation and anal ultrasound confirmed a C-shaped sphincter with the anterior part not surrounded by sphincter muscle.↗
▶Ep 158 · 7:12
clinicalThe rectal prolapse treated by the adult surgeon (mucosal plication) was interpreted as a late sign of the missing sphincter complex.↗
▶Ep 158 · 12:00
clinicalThe German transition model begins at age 12 by informing parents that the patient cannot stay in pediatric surgery forever; a network is built with adult colorectal surgeons interested in pediatric procedures, and connections are made to adult physiotherapists, urologists, and gynecologists.↗
▶Ep 158 · 12:00
guidelineIn Germany, pediatric surgeons are not allowed to treat patients over age 18, necessitating transition to adult care.↗
▶Ep 158 · 12:00
quoteIt depends, of course, on each patient, how is his ability to think about his own situation, their interests, and usually we do it like this, that at the age of 12 we talk to the parents that they cannot stay forever in the peat surgery department.↗
▶Ep 158 · 12:20
quoteWe are not allowed to treat over the age of 18 here in Germany, so we try to get them connected to adult colorectal surgeons.↗
▶Ep 158 · 13:04
clinicalDuring annual visits, the adult surgeon is present so both patient and surgeon get to know each other; the adult surgeon learns the patient's past medical history and the pediatric surgeon explains procedures. This 'soft transition' lasts 3–4 years with the goal that the patient eventually sees only the adult colorectal surgeon.↗
▶Ep 158 · 13:04
quotewhat we do is when we see them annually, we try to organize that the adult surgeon is present as well, so he gets to know the patient. And the patient gets to know the adult surgeon because usually they have another way of treating patients and This is something that the patient has to learn from the adult surgeon↗
