title: Pediatric inguinal and scrotal surgery - Practice patterns in U.S. academic centers.
abstract: OBJECTIVE
  Both pediatric urologists and pediatric surgeons perform hernia repairs, hydrocelectomies and orchiopexies. We hypothesized that surgeons perform more incarcerated and female hernia repairs while urologists perform more orchiopexies and hydrocelectomies.
  
  
  METHODS
  The Vizient-AAMC Faculty Practice Solutions Center® database was queried from January 2009 to December 2014 to identify patients 10years or younger who underwent the above procedures performed by pediatric specialists. Age, gender, race, insurance, geographic region and surgeon volume were examined.
  
  
  RESULTS
  In the study 55,893 surgeries were identified: 26,073 primary hernia repairs, 462 recurrent hernia repairs, 3399 laparoscopic hernia repairs, 9414 hydrocele repairs and 16,545 orchiopexies. Pediatric surgeons performed 89% of primary hernia repairs with an annual median surgeon volume of 4 cases/year. Pediatric urologists performed 62% of hydrocelectomies and 83% of orchiopexies with annual median surgeon volumes of 6 and 24, respectively. Pediatric surgeons performed all procedures in younger patients and performed more female and incarcerated hernia repairs.
  
  
  CONCLUSIONS
  Pediatric surgeons operate on younger patients and treat more patients with inguinal hernias while pediatric urologists care for more boys with undescended testes and hydroceles. This knowledge of referral patterns and care between specialties with overlapping expertise will allow improvements in training and access.
  
  
  METHODS
  Cost Effectiveness Study, Level of Evidence III.
authors: Department of Urology, University of California Davis Children's Hospital, Sacramento, CA, USA.
authors: Yvonne Y
authors: YY
authors: Chan
authors: Division of Biostatistics, University of California Davis, Davis, CA, USA.
authors: Blythe
authors: B
authors: Durbin-Johnson
authors: Department of Urology, University of California Davis Children's Hospital, Sacramento, CA, USA. Electronic address: eakurzrock@ucdavis.edu.
authors: Eric A
authors: EA
authors: Kurzrock
mesh_terms: D002648:Child; D002675:Child, Preschool; D003456:Cryptorchidism / Q000601:surgery; D016208:Databases, Factual; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery; D059685:Herniorrhaphy / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D056126:Orchiopexy / Q000706:statistics & numerical data; D010372:Pediatrics / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013043:Specialties, Surgical / Q000706:statistics & numerical data*; D006848:Testicular Hydrocele / Q000601:surgery; D014481:United States; D013521:Urologic Surgical Procedures, Male / Q000706:statistics & numerical data*; D014572:Urology / Q000706:statistics & numerical data*
keywords: Epidemiology; Hernia repair; Hydrocele; Practice pattern; Undescended testicle