Adults with congenital anomalies like bladder exstrophy-epispadias complex (BEEC) or spina bifida require lifelong surgical and multidisciplinary care. Although different in their undying pathology, patients with either of these conditions require regular urological follow-up to optimize health, functioning, and quality of life throughout their lives. Briefly, issues that need to be monitored include urinary concerns (continence, emptying, urinary tract infections, stone formation, etc.), renal function (upper tract deterioration, chronic kidney disease, etc.), sexual and reproductive function (erectile function, pregnancy, etc.), and psychosocial health. Adults with a history of urinary continent catheterizable channels, bladder neck procedures, and/or bladder augmentation warrant particular consideration, and troubleshooting suggestions are provided.