Transitional urology in congenital and neurological conditions: a global review of structured care models and clinical outcomes.

Abstract

<h4>Background</h4>Transitional urology bridges paediatric and adult care for patients with congenital and chronic urological conditions. However, the lack of standardized protocols and coordinated care has resulted in poor adherence, increased complications, and gaps in long-term management.<h4>Objectives</h4>This systematic review aims to provide a global overview of structured transition programs in congenital and neurological urology. It evaluates program design, implementation, and the role of healthcare providers-including transition coordinators and multidisciplinary teams-in delivering transitional care. The review further examines their impact on patient adherence, clinical outcomes (such as emergency visits and complications), and psychosocial readiness, while identifying gaps and barriers to improving care models worldwide.<h4>Methods</h4>A systematic literature search was conducted in PubMed, Embase, and Scopus databases using predefined MeSH terms and keywords. Inclusion criteria encompassed studies focusing on transitional care in urology for adolescents and young adults. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and the quality of included studies was assessed using the Newcastle-Ottawa Scale for risk of bias. Data on study characteristics, interventions, and outcomes were extracted and synthesized.<h4>Results</h4>A total of 20 studies met the inclusion criteria. Structured transition programs (e.g., dedicated multidisciplinary clinics) were associated with improved patient adherence and fewer emergency visits, with some studies reporting significant improvements in follow-up retention and reductions in complication rates. Psychosocial readiness factors (such as health literacy and family support) and family involvement emerged as primary predictors of successful transitions. However, significant barriers persist, including inadequate patient education, lack of transition coordinators, limited adult care access, and financial constraints. Geographical disparities were noted, with structured programs primarily reported in high-resource settings.<h4>Conclusions</h4>The transition from paediatric to adult urology remains inconsistent across healthcare systems. Structured programs with dedicated transition coordinators, patient education initiatives, and multidisciplinary collaboration significantly improve adherence and long-term outcomes for young urological patients. This comprehensive review underscores the need to develop standardized transition protocols, integrate digital health solutions, and address regional disparities. Future efforts should focus on ensuring seamless continuity of care for adolescents with chronic urological conditions through evidence-based transitional urology models.