How successful is the transition to adult urology care in spina bifida? A single center 7-year experience

• Published in: Journal of pediatric urology 2017-02, Vol.13 (1), p.40.e1-40.e6
• Main Authors: Szymanski, Konrad M, Cain, Mark P, Hardacker, Thomas, Misseri, Rosalia
• Format: Article
• Language: English
• Subjects: Adolescent; Ambulatory Care Facilities - standards; Female; Follow-Up Studies; Humans; Male; Pediatrics; Retrospective Studies; Self Care - standards; Spina bifida; Spinal Dysraphism - surgery; Surveys and Questionnaires; Time Factors; Transition to Adult Care - standards; Transitional urology; Urinary tract reconstruction; Urologic Surgical Procedures - methods; Urology; Young Adult
• ISSN: 1477-5131; 1873-4898
• DOI: 10.1016/j.jpurol.2016.09.020

Summary Introduction Rates of successful transition from adolescent to adult spina bifida (SB) care are unknown. Objective We aimed to assess rates and predictors of successful transition from a multidisciplinary SB clinic to a transitional urology clinic (TUC), or a pediatric or adult urologist. Study design We retrospectively reviewed patients discharged from a multidisciplinary SB clinic (2006–2012, see Figure ), collecting demographic and clinical data. At transition, all patients/families were given instructions to arrange an appointment within 12 months. Patients who followed-up within 2 years were classified as transitioned. Logistic regression was used for analysis. Results Of 77 patients discharged at a mean age of 19.1 years, 31 (40.3%) successfully transitioned (mean follow-up 4.7 years). Only 20/41 (48.8%) with prior bladder augmentation, urinary channel, and MACE transitioned. There was no significant change in patients transitioning over time or late catch-up presentations ( p ≥0.41). Transitioned and non-transitioned groups were similar in age, gender, home-to-clinic distance, insurance, ambulation, shunt status, prior non-adherence, emergency room visits, neurosurgery appointments, hospitalizations, and surgeries (including genitourinary reconstruction) before discharge ( p ≥0.22). Transitioned patients had more pre-discharge appointments with services outside the SB clinic ( p =0.01) and radiographic studies ( p