With this study, we would like to interview 16-25-year-olds who have experienced urinary problems since childhood and who are still experiencing symptoms in young adulthood. The transition from childhood, through puberty, to young adulthood is a time period marked by many psychological ans physiological changes, during which it can be difficult to properly monitor certain symptoms. With this study, we aim to gather opinions and experiences of adolescents and young adults in order to improve urological care for other patients in the future.

This study investigates the experiences of adolescents with urinary symptoms during the transition from pediatric to adult urological care. This transition is a complex, multidisciplinary process that impacts their well-being and treatment. Gaining insight into the perceptions of and barriers within this transition is crucial for improving care and guidance for future patients.

This mix-method study uses in-depth interviews and standardized questionnaires and focuses on adolescents (16-25 years) with a history of urinary symptoms who are currently being followed for these complaints. Data collection includes a timeline completion of the urological care pathway from birth untill the moment of the interview, semi-structured interviews, and questionnaires. Twenty participants will be included, with the possibility of expanding the sample or terminating recruitment early depending on interim results.

Participants will be recruited via healthcare providers at Ghent University Hospital (UZ Gent) from various departments: urology, pediatric urology, pediatric nephrology, and general practice, as well as through lecture evenings organized by UZ Gent for healthcare providers from peripheral settings (outside UZ Gent) involved in the care of adolescents with urinary symptoms. The informed consent form (ICF) will be provided first-signed by the participant in the case of adults, and, in the case of minors, through an informed assent form (IAF) completed by the participant and an informed consent form (ICF) signed by a parent or legal guardian. Subsequently, appointments for an introductory meeting and interview will be scheduled.

After the introductory meeting, participants will complete a timeline of their urological care pathway from birth to date and will independently collect their childhood growth curves, following instructions provided by the research team. The subsequent interview-if approved by the participant-will be audio-recorded, questionnaires will be completed, and all data will later be pseudonymized in accordance with GDPR guidelines. Interviews may take place at UZ Gent, at a preferred location, or via video consultation.

Inclusion Criteria:

• LUTS (according to ICCS definition) present during childhood
• Participants receiving follow-up care for LUTS from a general practitioner, urologist, paediatric urologist, or paediatric nephrologist.
• Individuals aged 16-25 years who have recently transitioned to adult care or are currently undergoing the transition process.

Exclusion Criteria:

• Patients not comfortable conducting interviews and completing questionnaires in Dutch
• Participants with neurological conditions or congenital anatomical anomalies that may cause LUTS, as these individuals are already followed in established transition pathways and cannot be compared to the target population
• Individuals with cognitive impairments that impair their capacity to independently participate in interviews or complete questionnaires.

The Study of Transition in Real-life Experiences Affecting Micturition and Well-being in Adolescent Years (STREAMWAY) aims to map perceptions, attitudes and experiences of adolescents who have undergone the transfer from paediatric to adult urological care. Participants should have received follow-up care for childhood LUTS from a general practitioner, urologist, paediatric urologist, or paediatric nephrologist. At the initial study visit, before enrolment, AYA patients with LUTS undergo a complete diagnostic work-up as part of standard care to determine the presence of LUTS at the time of consultation.

Maintaning confidentiality and patient safety. Data is entered manually on an online firewall-protected data registry on the password-encrypted server of Ghent University. Subsequently, data is stored in a central IBM SPSS database also protected by the institutional firewall. Pseudonymized qualitative and quantitative data are registered in separated data sets, accessible to the PI, trial coordinator, and co-investigators. Only the trial coordinator has access to a key file with pseudonymization codes linked to patient data.