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Treatment of vesico-ureteric reflux: a new algorithm based on parental preference
N Capozza1, A Lais, E Matarazzo
1Division of Paediatric Urology, 'Bambino Gesu' Children's Hospital, IRCCS, Rome, Italy. capozza@opbg.net
BJU International
|July 31, 2003
Summary
Most parents prefer minimally invasive endoscopic treatment for grade III vesico-ureteric reflux (VUR) in children. This preference informed a new treatment algorithm, prioritizing endoscopic management for persistent VUR.
Area of Science:
- Pediatric Urology
- Nephrology
- Surgical Innovation
Background:
- Vesico-ureteric reflux (VUR) in children can lead to renal damage.
- Grade III VUR lacks a definitive treatment, necessitating consideration of parental preferences.
- Parental input is crucial in treatment decision-making for pediatric VUR.
Purpose of the Study:
- To evaluate parental preferences for different treatment options for grade III VUR.
- To understand how parental preferences align with current treatment guidelines.
- To inform the development of a new VUR treatment algorithm.
Main Methods:
- A study involving 100 children with grade III VUR.
- Parents received detailed information on antibiotic prophylaxis, open surgery, and endoscopic treatment.
- Questionnaires assessed parental treatment preferences.
Main Results:
- 80% of parents preferred endoscopic treatment for VUR.
- Antibiotic prophylaxis was preferred by 5%, and open surgery by 2%.
- Endoscopic treatment was recommended for undecided parents.
Conclusions:
- Parental preference strongly favors endoscopic treatment for grade III VUR.
- A new treatment algorithm is proposed, prioritizing endoscopic management.
- Open surgery remains the recommendation for severe VUR cases.
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