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Outcomes of a newly established transitional urology outpatient clinic: a real-world experience

  • Urology - Original Paper
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Abstract

Purpose

To evaluate the demographic and clinical characteristics of patients who visited our transitional urology (TU) outpatient clinic formed by pediatric urologists with urology background within the first year upon its establishment.

Methods

Files of 130 consecutive patients who visited our TU outpatient clinic, which was established in 01 March 2021, between 01 March 2021 and 01 March 2022 were retrospectively collected. Patients were divided into two groups: those with a previous follow-up in our pediatric urology department (Group I, n: 81, 62.3%) and those who were followed up in other clinics during childhood (Group II, n: 49, 37.7%) afterwards. Demographic characteristics, complaints at admission, previous medical history, and management plans at the recent clinical visit were noted. We defined a successful and smooth transition from childhood to adult care as not being without follow-up within the first year after the age of 18 years and not requiring extraordinary medical assistance (e.g., emergency room visits, hospitalization, intensive care unit admissions) from the last urological control to the TU outpatient clinic visits.

Results

The most common diagnoses were vesicoureteral reflux (n: 32, 24.6%), neuropathic bladder accompanied by spina bifida (n: 31, 23.8%), obstructive uropathy (n: 25, 19.2%), hypospadias (n: 20, 15.3%), non-neurogenic lower urinary tract dysfunction (n: 19, 14.6%), and bladder exstrophy (n: 8, 6.1%). The distribution of primary diagnosis in the two patient groups was similar. The median time from the last pediatric urology visit to the current TU clinical visit was significantly longer in Group II (12 vs. 60 months, p < 0.001),consequently, the median patient age at admission was significantly higher in Group II (21 vs. 23 years, p = 0.020). The rate of a successful and smooth transition was 86.4% in Group I, whereas Group II had a completely unsuccessful transition period. Upon admission to TU outpatient clinic, the requirement of a surgical intervention was lower in Group I (21% vs. 38.8%, p = 0.028).Also,the need for medical treatment changes was higher in Group II (9.9% vs. 53.1%, p < 0.001).

Conclusion

Our findings emphasize the importance of patient referral to a TU clinic that deal with lifelong problems of congenital genitourinary diseases. Delays in receiving medical or surgical treatments during transition from childhood to adulthood may be associated with higher need for subsequent surgical interventions in this vulnerable patient population.

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Data availability

The datasets generated during and/or analyzed during the current study are not publicly available, but are available from the corresponding author on reasonable request.

Abbreviations

CIC:

Clean intermittent catheterization

IQR:

Interquartile range

LUTD:

Lower urinary tract dysfunction

LUTS:

Lower urinary tract symptoms

Max:

Maximum

Min:

Minimum

PUV:

Posterior urethral valve

TIP:

Tubularized incised plate

TU:

Transitional urology

UPJ:

Ureteropelvic junction

UTI:

Urinary tract infection

UVJ:

Ureterovesical junction

VUR:

Vesicoureteral reflux

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Funding

The authors declare that they have no relevant financial interests.

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Authors and Affiliations

  1. İstanbul Faculty of Medicine, Department of Urology, Division of Pediatric Urology, İstanbul University, Istanbul, Turkey

    M. İrfan Dönmez, Ismail Selvi, Anıl Tantekin, Tayfun Oktar & Orhan Ziylan

  2. School of Medicine, Department of Urology, Koç University, Istanbul, Turkey

    Tayfun Oktar

Authors
  1. M. İrfan Dönmez
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  2. Ismail Selvi
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Contributions

DMİ: conception and design, administrative, drafting of the manuscript, critical revision of the manuscript for important intellectual content, technical or material support. SI: acquisition of data, analysis and ınterpretation of data, statistical analysis, literature search, drafting of the manuscript. TA: acquisition of data, analysis and ınterpretation of data. OT: conception and design, administrative, critical revision of the manuscript for important intellectual content, supervision. ZO: administrative, critical revision of the manuscript for important intellectual content, supervision.

Corresponding author

Correspondence to M. İrfan Dönmez.

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Conflict of interest

The authors declare no conflicts of interest and has nothing to disclose.

Ethical approval

The study received Institutional Review Board approval (Ethical IRB number: 31.08.2022-1183856). All procedures performed in our study were in accordance with the ethical standards of the local research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was waived due to the retrospective nature of the study.

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Dönmez, M.İ., Selvi, I., Tantekin, A. et al. Outcomes of a newly established transitional urology outpatient clinic: a real-world experience. Int Urol Nephrol 55, 3021–3031 (2023). https://doi.org/10.1007/s11255-023-03732-9

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  • DOI: https://doi.org/10.1007/s11255-023-03732-9

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