MP08-19 FACTORS AFFECTING ORCHIOPEXY GUIDELINE ADHERENCE

This association did not hold up on multivariate analysis when controlling for age and type of repair (OR [ 1.3, 95%CI [ 0.8-2.2; p > 0.05). Caudal anesthesia was not associated with increased likeli-hood of complication < 30 days on either multivariate or univariate analysis. CONCLUSIONS: After controlling for possible confounders, caudal nerve block was not associated with increased risk of postoperative complications following distal hypospadias repair. The major strengths of this study are a large, homogenous study population, robust follow up and inclusion of data from 14 surgeons over 14 years. 18 MoA (hospital-level as random effect). Multiple imputations were used for missing observations. Sensitivity analysis (SA) was performed for 18 and 24 MoA. RESULTS: 89114 cryptorchid males had orchiopexy between 2009-2019; 59093 (66.3%) surgeries occurred (cid:4) 18 MoA. 45303 (50.8%) were White, and 42213 (47.4%) had public insurance. Increased odds of orchiopexy after 18 MoA correlates with Black or Hispanic (P < 0.001), self-pay/charity (P [ 0.007), higher-income quintile (P < 0.001), and lower comorbidity level (P < 0.001). Black (OR [ 1.22; 95% CI, 1.16-1.28; P < 0.001) and Hispanic (OR [ 1.19; 95% CI, 1.14-1.24; P < 0.001) were at increased odds of delayed orchiopexy compared to Whites. We did not attribute the associations of R/E, insurance, or income with the outcome to single hospitals. The highest income compared to lowest was associated with increased odds of surgery after 18 MoA at 29/34 hospitals (85%). Compared to private insurance, public correlates with increased odds of surgical delay at 13/34 hospitals (38%). SA with 24 MoA with similar results. CONCLUSIONS: Consistent with prior studies, orchiopexy remains delayed despite guidelines. In addition, Black, Hispanic, self-pay/ charity, and lower comorbidity were signi fi cantly associated with delay. This highlights a need to re fi ne provider education & outreach efforts to reduce disparities in care.