These authors from Indianapolis, USA, aimed to assess rates and predictors of successful transition into adult care of spina bifida patients. They did this by a retrospective review of 77 patients discharged from a multidisciplinary paediatric clinic at a mean age of 19.1 years after giving them instructions to arrange an appointment within 12 months in the adult service. Success was defined as documented follow-up in an adult clinic or with a previous paediatric or adult urologist at 24 months post discharge (patients having been given a choice of where to go for follow-up). Overall, 31 (40.3%) transitioned successfully (mean follow-up 4.7 years); of which 35.4% transitioned to their original urologist, and 58.1% to a new adult urologist (6.55% transitioned to an adult academic urologist). Seven patients presented late (24-36 months) to a new adult urologist. Of the late presenters, one presented with a new complaint. There was no difference in demographics between successful and unsuccessful transition patients. There was a trend towards patients who had attended an outpatient clinic within three years of transition, transitioning successfully. In addition a significant proportion of patients with spina bifida were lost to follow-up. The authors conclude that there is still a lot of work to be done to establish successful and adequate life-long follow-up and transition into adult care for these complex patients.
