Practice patterns among pediatric urologists in the use of Deflux® for vesicoureteral reflux: a survey.

Abstract

OBJECTIVES:

This study aims to assess pediatric urology practice patterns and factors which influence the use of Deflux(®) in the management of vesicoureteral reflux among pediatric urologists.

METHODS:

A 11-question survey was sent out to 476 pediatric urologists who are members of the Society for Pediatric Urology.

RESULTS:

23.7% of pediatric urologists use Deflux(®) as first line therapy for Grade III reflux or higher. The presence of renal scarring is not a deterrent to the use of Deflux(®). 17.7% would use Deflux(®) before a trial of observation with or without chemoprophylaxis. In children who are on observation, 20.3% would perform Deflux(®) when they are at an age considered appropriate for surgery as opposed to continued observation. The majority of pediatric urologists cite Deflux(®) success rates of >70% to >80% for Grades II-III and >50% to >60% for Grades IV-V. 23.3% of respondents indicated that new evidence citing low long-term success rates at one year decreased their use of Deflux(®). 59.8% of respondents indicated they would perform a second injection after an initial failure. Ultrasound and VCUG are used as follow-up in 86.9% and 65.4% respectively after Deflux(®); the majority are performed within the first 3 months, rarely at one year.

CONCLUSION:

The use of Deflux(®) is growing and whether it surpasses open reimplantation and chemoprophylaxis as first-line therapy remains to be seen. With new literature showing lower success rates, long-term follow-up with repeat imaging may be required.

• Authors: Gina M Cambareri, Moneer K Hanna, Jeffrey A Stock
• Journal: Journal of pediatric urology (J Pediatr Urol) Vol. 9 Issue 6 Pt A Pg. 955-61 (Dec 2013) ISSN: 1873-4898 [Electronic] England
• PMID: 23466044 (Publication Type: Journal Article)
• Copyright: Copyright © 2013 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Dextrans
• deflux
• Hyaluronic Acid

Topics

• Child
• Dextrans (therapeutic use)
• Health Care Surveys
• Humans
• Hyaluronic Acid (therapeutic use)
• Injections
• Pediatrics
• Professional Practice
• Prostheses and Implants
• Retreatment
• Treatment Outcome
• Urology
• Vesico-Ureteral Reflux (surgery, therapy)