We suggest that chlormethiazole may have caused dysphagia by a direct action on the central mechanisms concerned in swallowing. Most reports of the adverse effects of this drug concentrate on the problems of drug abuse and addiction,3 and dysphagia has not been reported as a side effect. There have been some reports of dyspepsia, nausea, and vomiting related to the acidity of the tablets.4 This is unlikely to have been important in the present case, however, since no reflux was detected during overnight recording. Further studies are needed to investigate the prevalence and mechanism of oesophageal dysfunction in patients taking this drug.

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Although retrospective in nature, these data suggest that delay of primary hypospadias repair into the teen years or beyond may result in more complications than currently accepted for infant hypospadias repair.

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The initial presentation of exstrophy variants can be confusing, often delaying initial treatment. Superior vesical fistulas permit continence without BNR due to an intact urinary sphincter. Variants such as epispadias with bladder prolapse and duplicate or skin covered exstrophy should be closed at birth with standardized techniques to promote bladder growth for later BNR. These cases are faced with the same long-term problems as the classic presentation. Cloacal variants can present with intact anal innervation, allowing a later Pena procedure.

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We thank the reviewers and the Journal for their support with this manuscript. We recognize the complex nature of this subject and are eager to get our submission right. Your input is greatly valued.Reviewer #2: I think the paper is improved and more logical in its flow in the current version. Thank you.However, it does not contain very much concrete information/advice and as such I believe it should be shortened. I suggested this in the previous review as well but the new version is longer than before.Further, the purpose of the statement still seem a bit unclear. I would suggest that the authors add a well-defined purpose at the end of the introduction so that the paper can be read in that context.An excellent suggestionwe have added this.Finally, for table 1, lower limits for observations should be noted. It is not really useful for the reader to know that some studies didn't report on the problem and this does not work as lower limits. Reviewer Comments 1 st review Comments to Author:Reviewer #1: The authors present a superficial review or consensus of the challenges posed by patients who need transitional urology care. This topic is not new. This paper would have been informative 5 years ago. As written, there are few or no relevant data, the English needs editing, and it does not add to the current literature. The resources used to meet in Copenhagen to finalize this paper could have been put to better use.We thank the reviewer for their comments. We agree that this is a topic that has been in existence since D.I.Williams, Christopher Woodhouse and Phillip Ransley (and others) began to provide lifelong care for these patients. To date it has been relatively easy to stimulate interest in paediatric urologists who have the cohort of older patientsit remains difficult to stimulate interest in adult practitioners where the need is becoming

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