Abstract
PURPOSE To give an overview of the multidisciplinary approach in the treatment, the definite solution and the specific problems which developed in this specific case. MATERIAL AND METHODS Retrospective analysis of the medical, nursing, physiotherapheutic and psychological history of this specific case as an example of case management by a pediatric urology nurse practitioner within a multidisciplinary team. RESULTS All different aspects of care problems of an eleven-year-old boy born with an obstructive ureterocele, reflux and secondary nephrogenic diabetes insipidus are reviewed and presented. In his first year he underwent right nephrectomy of an afunctional kidney due to reflux- nephropathy. Because of the obstructive ureterocèle he received a temporary ureterocutaneostomy on the left side. He has polyuria and mild renal insufficiency. At age 5 treatment for his incontinence was started. Many different treatment options with different success and outcome were applied. The specific problems and the definite solution (Bricker urostomy) will be presented and discussed. Also, a special focus will be given to the multidisciplinary approach, discussions with the child and parents, and different aspect from the patients point of view. CONCLUSIONS A multidisciplinary approach with extensive discussions and explanation of expected outcome as well as additional psychological, nursing and physiotherapeutic support for children and parents can be necessary in difficult cases, so assure that chosen solutions are accepted by the child and parents as their best option.
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