Abstract
Purpose of Review
To report on our experience in establishing a formal transition urology clinic in Victoria, Australia, and review current literature on transition urology processes, as well as identified challenges and future avenues for research and development in the field of transition and adolescent urology.
Recent Findings
Paediatric to adult urology transition processes are increasingly reported and supported by the literature; however, to date, there is no consensus on a best model. In 2013, a formal urology transition clinic was established between The Royal Children’s Hospital and The Royal Melbourne Hospital. Since then, 122 patients have been referred for transition, with the main reasons for referral being spina bifida (n=52), posterior urethral valve (n=11), and exstrophy (n=8). The transition rate success is 90.2%, and 27.3% of patients required reconstructive surgery.
Summary
Transition urology is an emerging and important field of urology that requires dedicated multi-disciplinary teams and collaboration to ensure continued care of the congenital urology patient in a patient-driven manner with goals focused on integration and independence. Our local experience results are comparable to global reports and further evidence of the importance of this process.
Similar content being viewed by others
Data Availability
No datasets were generated or analysed during the current study.
References
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
Wood D. Adolescent urology: developing lifelong care for congenital anomalies. Nat Rev Urol. 2014;11(5):289–96. https://doi.org/10.1038/nrurol.2014.71.
Morlacco A, Bianco M, Dal Moro F. Transitional care in urology: the road to independence. Nat Rev Urol. 2022;19(12):691–2. https://doi.org/10.1038/s41585-022-00653-7.
• Wood D, Baird A, Carmignani L, et al. Lifelong congenital urology: the challenges for patients and surgeons. Eur Urol. 2019;75(6):1001–7. https://doi.org/10.1016/j.eururo.2019.03.019. This recent review discusses challenges in transition urology.
Brandes SB. The practice of transition urology and congenitalism. Curr Opin Urol. 2016;26(4):342–3. https://doi.org/10.1097/MOU.0000000000000301.
Claeys W, Roth JD, Hoebeke P. Barriers in transitioning urologic patients from pediatric to adult care. J Pediatr Urol. 2021;17(2):144–52. https://doi.org/10.1016/j.jpurol.2020.12.020.
Woodhouse C. Adolescent Urology and Transitional Care. Eur Urol. 2015;68(5):745–6. https://doi.org/10.1016/j.eururo.2015.06.021.
Skokan AJ, Kovell RC. Advances and challenges in transitional urology: caring for adolescents and young adults with lifelong complex genitourinary conditions. Curr Urol Rep. 2018;19(4):26. https://doi.org/10.1007/s11934-018-0774-3.
Lambert SM. Transitional care in pediatric urology. Semin Pediatr Surg. 2015;24(2):73–8. https://doi.org/10.1053/j.sempedsurg.2015.01.004.
Suson KD. Transitional urology for male adolescents: what adult urologists should know. Curr Urol Rep. 2016;17(10):71. https://doi.org/10.1007/s11934-016-0630-2.
Blubaum A, Lewis J, Frimberger D, Slobodov G. 9-year evaluation of a transitional care program for congenital neurogenic bladder patients. Urology. 2023;180:285–90. https://doi.org/10.1016/j.urology.2023.06.023.
Lewis J, Frimberger D, Haddad E, Slobodov G. A framework for transitioning patients from pediatric to adult health settings for patients with neurogenic bladder. Neurourol Urodyn. 2017;36(4):973–8. https://doi.org/10.1002/nau.23053.
Dobrowolska-Glazar B, Chrzan R, Bagłaj M. Various aspects of transition of care for adolescents with urological conditions. Adv Clin Exp Med. 2022;31(2):157–63. https://doi.org/10.17219/acem/142758.
O’Kelly F, t’Hoen LA, Burgu B, et al. A cross-sectional analysis of paediatric urologists’ current practices, opinions and areas of perceived importance in the delivery of adolescent & transitional care. J Pediatr Urol. 2023;19(4):430.e1–8. https://doi.org/10.1016/j.jpurol.2023.04.023.
Klostermann BK, Slap GB, Nebrig DM, Tivorsak TL, Britto MT. Earning trust and losing it: adolescents’ views on trusting physicians. J Fam Pract. 2005;54(8):679–87.
Dönmez Mİ, Selvi I, Tantekin A, Oktar T, Ziylan O. Outcomes of a newly established transitional urology outpatient clinic: a real-world experience. Int Urol Nephrol. 2023;55(12):3021–31. https://doi.org/10.1007/s11255-023-03732-9.
Chan R, Scovell J, Jeng Z, Rajanahally S, Boone T, Khavari R. The fate of transitional urology patients referred to a tertiary transitional care center. Urology. 2014;84(6):1544–8. https://doi.org/10.1016/j.urology.2014.08.022.
Peycelon M, Misseri R. The basics of transition in congenital lifelong urology. World J Urol. 2021;39(4):993–1001. https://doi.org/10.1007/s00345-020-03116-z.
Wood D. Leading contributors to success of transitional urology units. Curr Opin Urol. 2017;27(1):7–10. https://doi.org/10.1097/MOU.0000000000000354.
Kovell RC, Skokan AJ, Wood DN. Transitional urology. Urol Clin North Am. 2018;45(4):601–10. https://doi.org/10.1016/j.ucl.2018.06.007.
Szymanski KM, Misseri R, Whittam B, Large T, Cain MP. Current opinions regarding care of the mature pediatric urology patient. J Pediatr Urol. 2015;11(5):251.e1–251.e2514. https://doi.org/10.1016/j.jpurol.2015.05.020.
Bägli DJ, Chua M. Transitional care and a lesson from the pandemic. J Pediatr Urol. 2021;17(2):153–4. https://doi.org/10.1016/j.jpurol.2021.01.026.
Scarberry KA, Gor RA, Kovell RC. Management of the transitional urology patient: the role of the adult reconstructive urologist. Curr Urol Rep. 2021;22(3):15. https://doi.org/10.1007/s11934-021-01035-z.
Leva NV, Copp HL, Quanstrom K, Hampson LA. Demographics and baseline care among newly transitioning adult congenital urology patients. J Pediatr Urol. 2020;16(4):476.e1–6. https://doi.org/10.1016/j.jpurol.2020.05.167.
Funding
No funding was received for this article.
Author information
Authors and Affiliations
Contributions
S.Y. and D.H. wrote the main manuscript, D.H. and S.P. collected the local experience data, and N.W. and S.E. oversaw and guided the process and reviewed the manuscript. All authors approved the final manuscript.
Corresponding author
Ethics declarations
Competing Interests
The authors declare no competing interests.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Yaiesh, S., Hopkins, D.T., Perera, S. et al. Transition Adolescent Functional Urology in 2024: Current Challenges and into the Future. Curr Bladder Dysfunct Rep (2024). https://doi.org/10.1007/s11884-024-00754-6
Accepted:
Published:
DOI: https://doi.org/10.1007/s11884-024-00754-6