Impact of race and ethnicity on clinical outcomes and recurrence post‐ureteral reconstruction
Abstract Introduction Ureteral stricture disease (UTSD) poses significant challenges in reconstructive urology, with recent advances highlighting disparities in healthcare outcomes based on race and ethnicity. This study investigates the impact of race and ethnicity on clinical outcomes following ur...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-12-01
|
| Series: | BJUI Compass |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/bco2.450 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850052563579174912 |
|---|---|
| author | Dhruv Puri Eric Cho Kian Ahmadieh Nishant Garg Cesar Delgado Benjamin Cedars Michael Witthaus Michael Pan Jill C. Buckley |
| author_facet | Dhruv Puri Eric Cho Kian Ahmadieh Nishant Garg Cesar Delgado Benjamin Cedars Michael Witthaus Michael Pan Jill C. Buckley |
| author_sort | Dhruv Puri |
| collection | DOAJ |
| description | Abstract Introduction Ureteral stricture disease (UTSD) poses significant challenges in reconstructive urology, with recent advances highlighting disparities in healthcare outcomes based on race and ethnicity. This study investigates the impact of race and ethnicity on clinical outcomes following ureteral reconstruction. Methods We conducted a single‐centre prospective analysis of 233 patients who underwent ureteral reconstruction for UTSD from 2014 to 2023. Patient demographics, clinical characteristics, surgical details and outcomes were collected. Patients were stratified by race (White vs. non‐White) and ethnicity (Hispanic vs. non‐Hispanic). Statistical analyses included Kruskal–Wallis, Mann–Whitney U tests, ANOVA, Kaplan–Meier analysis and multivariate logistic regression. Results Our cohort included 233 patients who underwent ureteroplasty with 108 (46.4%) non‐White patients, and 71 (30.5%) were Hispanic. No significant differences were found in recurrence rates, complications, or stricture‐free survival between racial and ethnic groups. Prior reconstructions were more prevalent among non‐White patients (26.9% vs. 16.0%; p = 0.043). Unadjusted and adjusted regressions showed significant associations between non‐White race (unadjusted β = 0.76, p = 0.008; adjusted β = 0.82, p = 0.008) and Hispanic ethnicity (unadjusted β = 0.70, p = 0.025; adjusted β = 0.79, p = 0.020) with increased stricture lengths. Conclusion This study highlights that although recurrence and complication rates do not significantly differ by race or ethnicity, disparities exist in clinical presentations, with non‐White and Hispanic patients presenting with longer stricture lengths and higher body mass index. These findings underscore the need for targeted interventions to address underlying disparities in healthcare delivery and access. |
| format | Article |
| id | doaj-art-9b64385121eb425884db8b7260bd7fdc |
| institution | DOAJ |
| issn | 2688-4526 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | BJUI Compass |
| spelling | doaj-art-9b64385121eb425884db8b7260bd7fdc2025-08-20T02:52:46ZengWileyBJUI Compass2688-45262024-12-015121255126210.1002/bco2.450Impact of race and ethnicity on clinical outcomes and recurrence post‐ureteral reconstructionDhruv Puri0Eric Cho1Kian Ahmadieh2Nishant Garg3Cesar Delgado4Benjamin Cedars5Michael Witthaus6Michael Pan7Jill C. Buckley8Department of Urology UC San Diego School of Medicine La Jolla California USAKaiser Permanente, Redwood City Medical Center San Francisco California USADepartment of Urology UC San Diego School of Medicine La Jolla California USADepartment of Urology UC San Diego School of Medicine La Jolla California USADepartment of Urology UC San Diego School of Medicine La Jolla California USADepartment of Urology UC San Diego School of Medicine La Jolla California USAUniversity of Maryland Capital Region Medical Center Baltimore Maryland USAKelsey‐Seybold Clinic Houston Texas USADepartment of Urology UC San Diego School of Medicine La Jolla California USAAbstract Introduction Ureteral stricture disease (UTSD) poses significant challenges in reconstructive urology, with recent advances highlighting disparities in healthcare outcomes based on race and ethnicity. This study investigates the impact of race and ethnicity on clinical outcomes following ureteral reconstruction. Methods We conducted a single‐centre prospective analysis of 233 patients who underwent ureteral reconstruction for UTSD from 2014 to 2023. Patient demographics, clinical characteristics, surgical details and outcomes were collected. Patients were stratified by race (White vs. non‐White) and ethnicity (Hispanic vs. non‐Hispanic). Statistical analyses included Kruskal–Wallis, Mann–Whitney U tests, ANOVA, Kaplan–Meier analysis and multivariate logistic regression. Results Our cohort included 233 patients who underwent ureteroplasty with 108 (46.4%) non‐White patients, and 71 (30.5%) were Hispanic. No significant differences were found in recurrence rates, complications, or stricture‐free survival between racial and ethnic groups. Prior reconstructions were more prevalent among non‐White patients (26.9% vs. 16.0%; p = 0.043). Unadjusted and adjusted regressions showed significant associations between non‐White race (unadjusted β = 0.76, p = 0.008; adjusted β = 0.82, p = 0.008) and Hispanic ethnicity (unadjusted β = 0.70, p = 0.025; adjusted β = 0.79, p = 0.020) with increased stricture lengths. Conclusion This study highlights that although recurrence and complication rates do not significantly differ by race or ethnicity, disparities exist in clinical presentations, with non‐White and Hispanic patients presenting with longer stricture lengths and higher body mass index. These findings underscore the need for targeted interventions to address underlying disparities in healthcare delivery and access.https://doi.org/10.1002/bco2.450health disparitiesrace and ethnicityrobot‐assisted ureteroplastyureteral stricture disease |
| spellingShingle | Dhruv Puri Eric Cho Kian Ahmadieh Nishant Garg Cesar Delgado Benjamin Cedars Michael Witthaus Michael Pan Jill C. Buckley Impact of race and ethnicity on clinical outcomes and recurrence post‐ureteral reconstruction BJUI Compass health disparities race and ethnicity robot‐assisted ureteroplasty ureteral stricture disease |
| title | Impact of race and ethnicity on clinical outcomes and recurrence post‐ureteral reconstruction |
| title_full | Impact of race and ethnicity on clinical outcomes and recurrence post‐ureteral reconstruction |
| title_fullStr | Impact of race and ethnicity on clinical outcomes and recurrence post‐ureteral reconstruction |
| title_full_unstemmed | Impact of race and ethnicity on clinical outcomes and recurrence post‐ureteral reconstruction |
| title_short | Impact of race and ethnicity on clinical outcomes and recurrence post‐ureteral reconstruction |
| title_sort | impact of race and ethnicity on clinical outcomes and recurrence post ureteral reconstruction |
| topic | health disparities race and ethnicity robot‐assisted ureteroplasty ureteral stricture disease |
| url | https://doi.org/10.1002/bco2.450 |
| work_keys_str_mv | AT dhruvpuri impactofraceandethnicityonclinicaloutcomesandrecurrencepostureteralreconstruction AT ericcho impactofraceandethnicityonclinicaloutcomesandrecurrencepostureteralreconstruction AT kianahmadieh impactofraceandethnicityonclinicaloutcomesandrecurrencepostureteralreconstruction AT nishantgarg impactofraceandethnicityonclinicaloutcomesandrecurrencepostureteralreconstruction AT cesardelgado impactofraceandethnicityonclinicaloutcomesandrecurrencepostureteralreconstruction AT benjamincedars impactofraceandethnicityonclinicaloutcomesandrecurrencepostureteralreconstruction AT michaelwitthaus impactofraceandethnicityonclinicaloutcomesandrecurrencepostureteralreconstruction AT michaelpan impactofraceandethnicityonclinicaloutcomesandrecurrencepostureteralreconstruction AT jillcbuckley impactofraceandethnicityonclinicaloutcomesandrecurrencepostureteralreconstruction |