Transitional urology: a comprehensive review of the transitional care process

When patients with congenital genitourinary conditions transition to adult care, they encounter multiple challenges, including management of multiple complex medical needs, understanding and navigating the healthcare system, and reconciling their condition with their social and psychological development. These issues translate directly into inferior short-term and long-term health outcomes, including increased emergency room visits after 18 years of age, persistent bothersome urinary symptoms, reduced quality of life and lack of appropriate urological management into adulthood. Conversely, smooth care transition enables improved age-appropriate subspecialty care and eases the burden of care on paediatric care providers. Transitional urology aims to aid adolescents and young adults, particularly those with complex healthcare needs, in successfully transitioning from paediatric to adult care. Transitional urology is one of the top ten highest-priority research topics in urology, but the existing body of research regarding transitional care remains relatively small. Knowledge and understanding of this patient population, including models of care, quantitative assessment of transition, stakeholder perspectives, common clinical challenges and barriers to establishing and maintaining transitional care programmes, can inform transitional care. Avenues of future transitional urology research include outcomes-based studies for specific pathologies, comparisons of different care implementation models, creation and evaluation of training opportunities and validation of resources created for non-urologic care team members. An idealized transition schema is proposed as both an example and guide to ground recommendations and data.