{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T12:18:56Z","timestamp":1788437936140,"version":"build-2803163510"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>\n                    A\n                    <jats:sc>BSTRACT<\/jats:sc>\n                  <\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Pelviureteric junction obstruction (PUJO), vesicoureteric reflux (VUR), hypospadias, and undescended testis (UDT) (cryptorchidism) are among the most commonly encountered conditions in pediatric urology practice. However, caregiver online health-seeking behavior for these conditions remains poorly characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To compare symptom-seeking versus treatment-seeking online search behavior for these four conditions globally (2004\u20132024) and assess the impact of the coronavirus disease 2019 (COVID-19) pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Retrospective infodemiology study using Google Trends relative search volume data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Google Trends were queried globally at monthly resolution for 2004\u20132024. For each condition, 10 search terms \u2013 selected using prespecified criteria of clinical plausibility, lay vocabulary fidelity, and nonredundancy \u2013 were divided into symptom-seeking and treatment-seeking groups. A shared anchor term enabled cross-group normalization to yield a monthly symptom-to-treatment (S: T) ratio. Spearman correlation assessed temporal trends; the Kruskal\u2013Wallis test with Bonferroni correction evaluated inter-entity differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Hypospadias showed the highest treatment-seeking volume and the lowest S: T ratio (0.003 \u00b1 0.027), indicating persistent treatment-dominant searching throughout. UDT demonstrated a significant increasing S: T trend (\n                      <jats:italic toggle=\"yes\">\u03c1<\/jats:italic>\n                      =0.845,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.034). PUJO had the highest mean S: T ratio (0.214 \u00b1 0.584), peaking at 1.75 in 2016. VUR returned only seven active months. COVID-19 suppressed PUJO searches while hypospadias remained stable. Inter-entity S: T differences were statistically significant (Kruskal\u2013Wallis\n                      <jats:italic toggle=\"yes\">H<\/jats:italic>\n                      = 7.89,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.048).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Significant differences exist in online caregiver health-seeking behavior across the four most common pediatric urological conditions, identifying condition-specific gaps in digital health literacy and targets for focused caregiver education.<\/jats:p>\n                  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