Fundació Puigvert has been designated a reference unit (CSUR) for exstrophy-epispadias complex in children and for complex glomerular diseases in adults. Accreditation has been attained as a comprehensive unit at Hospital de la Santa Creu i Sant Pau, a centre where multidisciplinary teams have been trained in the treatment of these pathologies. CSURs are reference centres, services or units within the Spanish National Health Service that are established by the Ministry of Health, Social Services and Equality. CSUR certification is awarded only to health centres whose activities are dedicated to specific pathologies or groups of pathologies which are considered to be rare diseases and which require a high level of specialisation and advanced technology for their prevention, diagnosis or treatment. To be accredited as a CSUR, centres must demonstrate adequate knowledge and experience, have a sufficient volume of activity in the relevant techniques, technology and procedures and be able to demonstrate indicators of adequate results. Designation as a CSUR therefore represents recognition of Fundació Puigvert’s experience with these pathologies within the specialties of Urology and Nephrology, fields in which Fundació Puigvert has been a pioneer for many years. Its recent designation as a CSUR is in addition to its accreditation for cross-kidney transplantation, received in December 2010.
The CSUR coordinator for exstrophy-epispadias complex (CEE) is Dr. Anna Bujons, head of the Paediatric Urology Unit at Fundació Puigvert. CEE represents a spectrum of genitourinary malformations with differing degrees of severity. Depending upon its severity, CEE can affect the urinary system, the musculoskeletal system, the pelvis, the pelvic floor, the abdominal wall, the genitals and, sometimes, the vertebral column and anus. Complex glomerular diseases of the kidney have been managed at Fundació Puigvert since the 1960s and currently 350 patients are undergoing treatment in the Nephrology Department, the coordinator of which is Dr. José Ballarín. They represent a group of heterogeneous diseases that affect the renal glomerulus and cause functional and structural disorders. The Ministry of Health, Social Services and Equality requires that CSURs cover the entire national territory and offer equal access to all patients, independent of their place of residence. In addition, care at CSURs must be provided by a multidisciplinary team, covering health care, support for diagnostic confirmation, and definition of therapeutic and monitoring strategies, and CSURs must also act as consultants for the clinical units that regularly treat these patients. Moreover, continuity of care must be guaranteed between the different life stages of the patient, from childhood to adulthood, and between care levels. Likewise, CSURs are committed to evaluating results and providing training to other professionals. Any service or unit proposing to become a CSUR must have the appropriate health care authorisation and a favourable report from the regional government responsible for the area in which the CSUR is located.