Public Online Search Behavior for Pediatric Urology Conditions: A Google Trends Infodemiology Analysis of Symptom Awareness versus Treatment-seeking Interest across Four Entities (2004-2024).

BACKGROUND

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.

OBJECTIVE

To compare symptom-seeking versus treatment-seeking online search behavior for these four conditions globally (2004-2024) and assess the impact of the coronavirus disease 2019 (COVID-19) pandemic.

STUDY

DESIGN

Retrospective infodemiology study using Google Trends relative search volume data.

METHODS

Google Trends were queried globally at monthly resolution for 2004-2024. For each condition, 10 search terms - selected using prespecified criteria of clinical plausibility, lay vocabulary fidelity, and nonredundancy - 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-Wallis test with Bonferroni correction evaluated inter-entity differences.

RESULTS

Hypospadias showed the highest treatment-seeking volume and the lowest S: T ratio (0.003 ± 0.027), indicating persistent treatment-dominant searching throughout. UDT demonstrated a significant increasing S: T trend (ρ =0.845, P = 0.034). PUJO had the highest mean S: T ratio (0.214 ± 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-Wallis H = 7.89, P = 0.048).

CONCLUSIONS

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.