Surgical Disparities in Pediatric Urology

Abstract

Health disparities exist in surgical care and outcomes, but have not been investigated thoroughly in pediatric urology. Our aim was to investigate the association of race and ethnicity with timing of surgery and 30 day complications after orchiopexy, hypospadias repair, and urinary continence surgery. We performed a retrospective cohort study of individuals <18 years of age as captured in the NSQIPP PUF from 2012-2016. Primary outcomes of interest were age at time of surgery, proportion undergoing surgery by recommended age, likelihood of CKD at time of bladder augmentation, and 30 day complications. Logistic regression and generalized linear models were created. We found that non-Hispanic white race/ethnicity was associated with younger age at time of orchiopexy and hypospadias repair, several months earlier compared to Hispanic and non-Hispanic black individuals. Race/ethnicity was not associated with age at time of continence surgery or CKD at time of bladder augmentation. Non-Hispanic black race/ethnicity was associated with greater odds of complication after hypospadias repair. There are unexplained delays in surgery for racial and ethnic minorities with cryptorchidism and hypospadias. Further investigation is warranted to determine the factors contributing to these disparities.