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ArticleCanadian Urological Association journal = Journal de l'Association des urologues du Canada2025

Does marginalization status and distance from the hospital impact the timing of pediatric pyeloplasty in a universal access-to-care system?

Adree Khondker, Rahim Dhalla, David-Dan Nguyen, Jethro C C Kwong, Yerin Lee, Jeremy Wu, Jin Kyu Kim, Michael E Chua, Mandy Rickard, Armando J Lorenzo

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Article in Canadian Urological Association journal = Journal de l'Association des urologues du Canada, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Reporting of race and ethnicity in studies of artificial intelligence in pediatric urology A secondary analysis of the AI-PEDURO online repository.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Adree KhondkerDivision of Urology, The Hospital for Sick Children, Toronto, ON, Canada.
Rahim DhallaSchulich School of Medicine, Western University, London, ON, Canada.
David-Dan NguyenDivision of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Jethro C C KwongDivision of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Yerin LeeTemerty School of Medicine, University of Toronto, Toronto, ON, Canada.
Jeremy WuDivision of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Jin Kyu KimDivision of Urology, The Hospital for Sick Children, Toronto, ON, Canada.
Michael E ChuaDivision of Urology, The Hospital for Sick Children, Toronto, ON, Canada.
Mandy RickardDivision of Urology, The Hospital for Sick Children, Toronto, ON, Canada.
Armando J LorenzoDivision of Urology, The Hospital for Sick Children, Toronto, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPrior research in the U.S. suggests that marginalized populations tend to undergo pyeloplasty earlier, likely reflecting concerns about the challenges of reliable followup care in this population. This study assessed the effect of sociodemographic marginalization and geographic distance on the timing of pyeloplasty in a universal, single-payer healthcare system.

methodsWe performed a single-center, retrospective study on children undergoing pyeloplasty from 2008-2019. We assessed the impact of marginalization indices (with the Ontario Marginalization Index [ON-Marg]) and geographic distance on timing of pyeloplasty, preoperative ultrasound findings, and renogram features. Unadjusted analysis and Cox proportional regression were performed to determine the effect of marginalization and geography on timing of pyeloplasty.

resultsAmong 503 patients who underwent pyeloplasty, the median age at surgery was 16 months. Median preoperative anteroposterior diameter (APD) was 22 mm, and split renal function on renogram was 43%. There was no significant effect of marginalization indices on age at surgery. Patients living >50 km from the hospital had a later age at surgery than those living <10 km (p=0.04); however, there was no significant difference in preoperative APD or split function by marginalization index or geographic distance. Adjusted analyses revealed no significant associations between ON-Marg variables or geographic distance with age at surgery.

conclusionsIn a universal healthcare system, marginalization status and geographic distance were not associated with the timing of pyeloplasty. These results contrast with literature from other settings and suggest that access to care can mitigate disparities in pediatric urology care.

Identifiers

PMID40273407
PMCPMC12327892

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.