Association Between Social Determinants of Health and Choice of Urinary Reconstruction in Children

The study was a single institution retrospective study of 208 patients with neurogenic bladder, anorectal malformations, myelomeningocele, and other spinal cord pathology who underwent urinary reconstruction between 2014 and 2021

About 74% of patients underwent continent reconstruction and 26% underwent incontinent reconstruction

There was no difference in reconstruction type based on insurance type

There was no difference in reconstruction type based on childhood opportunity index

Patients who had incontinent reconstruction were more likely to have food insecurity

Patients who had incontinent reconstruction were more likely to have missed appointments

Patients who had incontinent reconstruction were more likely to have unmarried parents

Patients who traveled from out of state were more likely to have a continent diversion

Social stability and the ability to engage with follow-up may be influencing what surgeons offer families as well as what families can realistically manage

The best reconstruction isn't just one that's technically feasible, it also needs to be sustainable for patients and their families