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.
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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)
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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)
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