Transitioning young adults with spina bifida: Challenges and paths to success

J Pediatr Urol. 2024 Apr;20(2):200-210. doi: 10.1016/j.jpurol.2023.09.009. Epub 2023 Sep 20.

Abstract

Introduction and background: Recent medical advances, including closure of myelomeningocele defects, shunting of hydrocephalus, and focusing on renal preservation have led to many individuals with spina bifida (SB) living into adulthood. This has led to more individuals with SB transitioning their care from pediatric-based to adult-based care models.

Objective: We seek to explore the process of transition, with a focus on difficulties in transitioning individuals with SB. Additionally, we explore new problems that arise during the period of transition related to sexual function and dysfunction. We also discuss some of the difficulties managing neurogenic bladder and the sequalae of their prior urologic surgeries.

Study design: Each of the authors was asked to provide a summary, based on current literature, to highlight the challenges faced in their area of expertise.

Conclusions: Transitioning care for individuals with SB is especially challenging due to associated neurocognitive deficits and neuropsychological functioning issues. Sexual function is an important component of transition that must be addressed in young adults with SB. Management of neurogenic bladder in adults with SB can be challenging due to the heterogeneity of the population and the sequelae of their prior urologic surgeries. The aim is to ensure that all individuals with SB receive appropriate, evidence-based care throughout their lifetime.

MeSH terms

  • Child
  • Humans
  • Hydrocephalus* / complications
  • Meningomyelocele* / complications
  • Spinal Dysraphism* / complications
  • Spinal Dysraphism* / psychology
  • Spinal Dysraphism* / therapy
  • Urinary Bladder, Neurogenic* / complications
  • Urinary Bladder, Neurogenic* / therapy
  • Urologic Surgical Procedures
  • Young Adult