Transition Readiness and Independence Are Associated with Sexual Activity Among Adolescents and Young Adults with Congenital Urologic Conditions.

OBJECTIVE

To describe sexual activity, sexual function, fertility interest, and associations with transition readiness and independence among adolescents and young adults with congenital urologic conditions.

METHODS

We studied patients seen in a Transitional Urology Clinic from August 2024 to August 2025. Participants completed SHIM (Sexual Health Inventory for Men) or FSFI-6 (Female Sexual Function Index-6) and TRAQ (Transition Readiness Assessment Questionnaire) assessments.

RESULTS

Thirty-seven patients were included; 29 had neurogenic bladder. Eight (21.6%) reported sexual activity and 30 (81.1%) met sexual dysfunction criteria. Sexual activity was lower in neurogenic bladder than non-neurogenic conditions (15.4% vs 57.1%, p=0.042). Sexually active participants were more likely to live independently (87.5% vs 20.0%, p=0.001), be their own legal guardians (100% vs 58.3%, p=0.035), and have higher TRAQ scores (100 vs 79, p=0.013).

CONCLUSIONS

Sexual dysfunction was common among adolescents and young adults with congenital urologic conditions, regardless of neurologic status. Greater independence and higher transition readiness scores were associated with sexual activity and more favorable sexual health outcomes, suggesting that sexual health is closely linked to developmental readiness. These findings support incorporating sexual health assessment and counseling as a routine component of transitional urologic care.