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Racial variation in timing of pyeloplasty: prenatal v... [J Urol. 2011] - PubMed - NCBI

Racial variation in timing of pyeloplasty: prenatal v... [J Urol. 2011] - PubMed - NCBI

J Urol. 2011 Dec;186(6):2386-91. Epub 2011 Oct 20.

Racial variation in timing of pyeloplasty: prenatal versus postnatal diagnosis.

Source

Department of Urology, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts 02115, USA.

Abstract

PURPOSE:

We have previously shown that nonwhite patients with ureteropelvic junction obstruction undergo pyeloplasty at a younger age than white patients. The mechanisms behind this finding are unclear, since there is no known racial variation in the natural history of ureteropelvic junction obstruction. We used a detailed clinical database to explain this phenomenon.

MATERIALS AND METHODS:

We retrospectively reviewed all patients undergoing primary pyeloplasty at our institution between 1992 and 2008. More than 360 data points were abstracted for each patient, including self-reported race, socioeconomic status, symptom duration and presentation.

RESULTS:

Of 847 patients undergoing pyeloplasty during the study period 741 met inclusion criteria. Nonwhite patients underwent surgery at a younger age (0.6 years) than whites (2.6 years, p <0.0001). When stratified by timing of clinical presentation (prenatal vs postnatal), there was no significant difference in race among patients presenting prenatally (0.37 vs 0.36 years, p = 0.22). Nonwhite patients presenting postnatally were significantly younger than white patients (6.3 vs 8.2 years, p = 0.03). This finding appeared to be due to differences in age at initial clinical presentation (5.4 vs 7.0 years, p = 0.03) and in time from initial clinical presentation to urological evaluation (0.6 vs 3.2 months, p = 0.03). These differences persisted after correcting for other factors, including markers of socioeconomic status.

CONCLUSIONS:

Consistent with previous studies, we found that nonwhite patients underwent primary pyeloplasty at a younger age than whites. This difference is limited to patients presenting after birth. Prenatally diagnosed patients underwent surgery at similar ages regardless of race.
Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

PMID:
22014821
[PubMed - indexed for MEDLINE]

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