Urologic practice patterns of pediatricians: a survey from a large multisite pediatric care center

Courtney A. Stewart, Soo Jeong Kim, Daniel Phillips, Vinaya Bhatia, Nicolette Janzen, Jonathan A. Gerber

Research output: Contribution to journalArticlepeer-review


Objective: To evaluate the practice patterns of pediatricians as they relate to common urologic concerns. Materials and methods: An anonymous 15-question survey was created and distributed to all pediatricians at our institution, a large multisite care center. This study was deemed exempt by the institutional review board. Results: 55 of the 122 (45%) providers queried responded. 93% of the participants were female, and 7.3% were male. 55% recommended testicular self-examination at adolescence, while 39% did not recommend at any age. 78% stated that they were “Fairly confident” in the exam for undescended testicle (UTD). One-third referred patients with UDT to a subspecialist upon recognition at birth, 13% at 3 months of age, and 28% at 6 months of age. 10% reported obtaining a VCUG after the first febrile urinary tract infection (UTI), 26% after the second, and 36% only if there were abnormal findings on renal ultrasound. 28% of providers reported that they refer to pediatric urology after the initial febrile UTI. 19% provided antibiotics for UTI symptoms alone with negative urinalysis and urine culture. Conclusions: Despite established guidelines, practice patterns varied among pediatricians. Pediatricians typically followed the AAP's guidelines regarding VCUGs (62%), with only a few adhering to urologic recommendations (9%). Despite the consistency between AAP and AUA guidelines regarding the age at which to refer a patient for cryptorchidism, about 70% of practitioners referred patients too early or too late. Harmonized, consolidated guidelines between pediatricians and pediatric urologists would improve patient care and efficiency of the healthcare system.

Original languageEnglish (US)
Article number1278782
JournalFrontiers in Pediatrics
StatePublished - 2023
Externally publishedYes


  • pediatrician
  • practice pattern
  • referral
  • undescended testis
  • urinary tract infection
  • vesicoureteral reflux

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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