Adult Urologic Care for Childhood-Onset Conditions: Transition Failures, Access Barriers, and Models That Work

Purpose of Review To review failures in transition from pediatric to adult urologic care for childhood-onset conditions, barriers to access, and models associated with better outcomes. Recent Findings Adults with congenital urologic conditions remain at risk for renal deterioration, recurrent infection, and late complications of reconstructive surgeries. Unstructured transfer is associated with poor follow-up, increased emergency utilization, and preventable morbidity. Major barriers include limited adult provider expertise, fragmented referral processes, insurance and durable medical equipment restrictions, and psychosocial challenges affecting readiness and self-management. Multidisciplinary transition clinics, joint pediatric-adult care, readiness assessment, family-supported self-management, and telehealth have shown promise in improving retention and continuity. Summary Transition should be a longitudinal, developmentally informed process supported by coordinated teams, engagement of patients and their families, and systems that ensure equitable lifelong access to adult congenital urologic care.