Bridging childhood and adulthood: the evolving landscape of transitional urology

This addition marks an important evolution in paediatric urology, acknowledging the lifelong continuum of care required for many congenital and functional urological conditions. While surgical outcomes and survival rates have improved dramatically, long-term follow-up and integration into adult care remain inconsistent. Transition is not a single event but a structured process beginning in adolescence, ideally between ages 12 and 16, with both paediatric and adult urologists involved. The goal is to maintain renal function, continence, and sexual health while empowering young patients toward autonomy.

The panel stresses that standardised transition programmes, validated readiness assessment tools, and multidisciplinary communication are key to successful outcomes. Barriers often arise from differing expectations between patients, caregivers, and healthcare providers, highlighting the need for shared planning and continuity. 

A dedicated Journal of Paediatric Urology publication (Skott et al., JPU 2025, in press, DOI: 10.1016/j.jpurol.2025.10.002) summarises the EAU–ESPU Guidelines on Transition in Urology. This represents the first comprehensive guideline chapter devoted entirely to transition across paediatric urology. Transition is the process by which adolescents with congenital or acquired urogenital anomalies assume greater responsibility for their own care, ensuring lifelong surveillance and support through adult services.

The paper outlines condition-specific needs for patients with neurogenic bladder, posterior urethral valves, hypospadias, bladder exstrophy-epispadias complex, and differences of sex development. Structured recommendations are provided: begin transition early, involve both paediatric and adult specialists, and use validated readiness tools. A gradual introduction of the adult care team, several years before transfer, is encouraged to build trust and facilitate continuity.

Together, these two guideline publications highlight that urological care is increasingly lifelong. As more children with congenital conditions reach adulthood, the interface between paediatric and adult urology becomes central to outcome quality. Establishing dedicated transition clinics, shared electronic records, and cross-specialty communication will be vital in the coming years.

Transition is no longer a peripheral topic; it is the next frontier in ensuring that the gains achieved during childhood are sustained across the patient’s lifespan.