Neighborhood Disadvantage Lacks Correlation With Delayed Orchiopexy for Congenital Cryptorchidism

Area of Science:

• Pediatric Surgery
• Urology
• Public Health

Background:

• Orchiopexy for congenital cryptorchidism is recommended by 18 months of age for optimal outcomes.
• This study investigates if neighborhood disadvantage, using Social Vulnerability Index (SVI) and Area Deprivation Index (ADI), impacts the timing of orchiopexy.

Purpose of the Study:

• To determine the correlation between neighborhood disadvantage (SVI, ADI) and delayed orchiopexy in pediatric patients.
• To analyze factors influencing the age at referral and surgical intervention for cryptorchidism.

Main Methods:

• Retrospective cohort study of 149 patients under 18 years undergoing orchiopexy for cryptorchidism.
• Analysis of patient demographics, comorbidities, and surgical details.
• Correlation of Social Vulnerability Index (SVI) and Area Deprivation Index (ADI) with age at referral and surgery.

Main Results:

• Median age at referral was 10.5 months and at surgery was 15.6 months; 53.7% had surgery by 18 months.
• No significant difference in referral or intervention age was found between high-risk and low-risk SVI groups or across ADI quartiles.
• Complication rates were similar regardless of SVI status or ADI quartile.

Conclusions:

• A significant proportion of patients (46.3%) do not undergo timely orchiopexy, aligning with national trends.
• Neighborhood disadvantage, as indicated by SVI and ADI, does not appear to be a significant factor in delayed orchiopexy.
• Further research is required to identify specific barriers and interventions to improve timely surgical management of cryptorchidism.