Easing the transition from pediatric to adult urological care

The Clinic for Adolescent and Adult Pediatric Onset Urology (CAPITUL) serves those affected by urological conditions acquired in childhood, congenitally or otherwise. The clinic works with patients to manage a range of conditions, including pelvic and reproductive cancers, bladder and cloacal exstrophy, posterior urethral valves, epispadias, varicoceles, and neuropathic bladder complications stemming from spina bifida or spinal cord injuries. In addition to medical care, the clinic addresses the psychosocial impacts of urological disease, as well as cosmetic and sexual outcomes.

“Many pediatric urological conditions require long-term management, so transition of care is essential,” says Michael H. Hsieh, MD, PhD, pediatric urologist and Director, Transitional Urology at Children’s National. “Additionally, childhood urological issues often are accompanied by genetic disorders that affect cognitive development, so continued pediatric care may be appropriate for these patients into adulthood.”

For children with developmental deficits, CAPITUL provides social work, patient navigation, and other support framework to help guide families through the difficult questions regarding long-term dependent care.

Patients who receive pediatric urological care at Children’s National are referred to CAPITUL at the appropriate age and attended by Dr. Hsieh at Children’s National and the George Washington University (GW) Hospital or an affiliated satellite clinic. Children’s National serves as the primary point of care in the transition phase until a patient is comfortable receiving full adult urological care at GW.

Says Dr. Hsieh, “It is important to balance standards of care with the patient’s individual needs—whether that means delaying transition to adult care or integrating pediatric and adult care long-term.”