Mp72-03 Unveiling Regional Disparities in Pediatric Varicocele Care: A Global Survey

You have accessJournal of UrologyPediatrics VII (MP72)1 May 2024MP72-03 UNVEILING REGIONAL DISPARITIES IN PEDIATRIC VARICOCELE CARE: A GLOBAL SURVEY Adele Raymo, Luciana Lerendegui, Daniel Tennenbaum, Rajiv Tummala, George Andrew Ransford, Andrew Labbie, Rafael Gosalbez, Miguel Castellan, Daniel E. Nassau, and Alireza Alam Adele RaymoAdele Raymo , Luciana LerendeguiLuciana Lerendegui , Daniel TennenbaumDaniel Tennenbaum , Rajiv TummalaRajiv Tummala , George Andrew RansfordGeorge Andrew Ransford , Andrew LabbieAndrew Labbie , Rafael GosalbezRafael Gosalbez , Miguel CastellanMiguel Castellan , Daniel E. NassauDaniel E. Nassau , and Alireza AlamAlireza Alam View All Author Informationhttps://doi.org/10.1097/01.JU.0001009572.60675.69.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Despite the high incidence of varicocele, there remains a substantial lack of consensus on the best approach to diagnosis and treatment. The aim of our study is to assess regional differences in the workup and management of pediatric varicoceles amongst physicians practicing in Europe (EU), North America (NA), and Ibero-America (IA). METHODS: A survey consisting of 21 multiple choice and free response questions was sent to three different pediatric urology societies (ESPU, SPU, and SIUP). Responses were collected anonymously via SurveyMonkey. Z-score was used to assess significance. RESULTS: There were 400 physician responses, 81 from EU, 130 from IA, and 169 from NA. Twenty were outside of these regions and were excluded. We found an increased propensity for EU and IA physicians to consider varicocele grade as an indication for surgery in prepubertal patients (z-score=2.4 & 4.4) and post-pubertal patients (z-score=3.6 & 3.2 respectively), whereas NA physicians were more inclined to select abnormal semen analysis (SA) in post-pubertal patients (z score=3.3). For case management of a post-pubertal patient with a G3 varicocele, testicular volume discrepancy >20%, total testicular volume >30cc and normal SA, IA physicians favored surgical intervention, while NA physicians preferred active surveillance (Z-score=3.4 & 3.3). Regarding type of varicocelectomy, physicians in EU were more inclined to choose laparoscopy and sclerotherapy (z-score=2.3 & 5.4) while those in IA preferred the inguinal/sub-inguinal approach (z-score=2.5). EU physicians leaned towards the non-artery sparing technique (z-score=2.1) while IA physicians chose artery sparing (z-score=2.4). These associations were statistically significant (p1.96). When asked about challenges with requesting SA for adolescent patients, physicians in NA Significantly reported high cost, lack of lab accessibility, and patient/parental refusal barriers to obtaining SA (z-score=4.7, 3.2, & 3.7 respectively). While physicians in EU significantly reported not having any difficulties requesting SA (z-score=2.1), and physicians in IA reported not ordering SA altogether (z-score=5.9). CONCLUSIONS: Significant regional differences were found in pediatric varicocele management amongst physicians in Europe, Ibero-America and North America. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1172 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Adele Raymo More articles by this author Luciana Lerendegui More articles by this author Daniel Tennenbaum More articles by this author Rajiv Tummala More articles by this author George Andrew Ransford More articles by this author Andrew Labbie More articles by this author Rafael Gosalbez More articles by this author Miguel Castellan More articles by this author Daniel E. Nassau More articles by this author Alireza Alam More articles by this author Expand All Advertisement PDF downloadLoading ...