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Updated: Jul 4, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Factors involved in parental decision making for surgical correction of vesicoureteral reflux
Katherine Callaghan1, Eileen Gray, Anthony Caldamone
1Hasbro Children's Hospital, Warren Alpert Medical School at Brown University, Providence, Rhode Island, USA.
Insights
Parental decisions for pediatric vesicoureteral reflux surgery prioritize success for open procedures and minimally invasive approaches for endoscopic correction. Satisfaction varies based on outcomes, particularly after endoscopic treatment failure.
Area of Science:
- Pediatric Urology
- Surgical Outcomes Research
Background:
- Vesicoureteral reflux (VUR) management has evolved with minimally invasive endoscopic techniques.
- Parental decision-making factors and satisfaction with VUR surgical options require evaluation.
Purpose of the Study:
- To identify factors influencing parental choice between open reimplantation and endoscopic correction for VUR.
- To assess parental satisfaction following surgical VUR treatment.
Main Methods:
- Retrospective review of 77 VUR surgical cases over three years.
- Telephone survey assessing decision-making factors and satisfaction.
Main Results:
- For open reimplantation (52 cases), success (90.4%) and long-term history (57.7%) were key parental considerations.
- For endoscopic correction (25 cases), invasiveness (84%) and success (52%) were paramount.
- High satisfaction with open surgery (96% would choose again); lower satisfaction with failed endoscopic correction (13% would not choose again).
Conclusions:
- Parental priorities differ between open and endoscopic VUR surgery.
- Success is a critical factor for open surgery choice and satisfaction.
- Minimally invasive nature and success influence endoscopic choice, but outcomes significantly impact satisfaction.
Purpose:
Surgical management of vesicoureteral reflux has changed with the use of endoscopic correction. We evaluated the possible factors that may affect parental decision making with regard to this procedure, and assessed subsequent parent satisfaction.
Materials And Methods:
We retrospectively reviewed the records of patients who underwent surgery for vesicoureteral reflux during a 3-year period. We used a telephone based survey, rating factors affecting decision making and overall satisfaction.
Results:
A total of 74 parents of children 1.5 to 18 years old participated in the study, and 77 procedures were evaluated. Among the 52 cases of open reimplantation success was rated as "most important" in 47 (90.4%) and long-term history was rated as "most important" in 30 (57.7%). Among the 25 cases of endoscopic correction success was rated as "most important" in 13 (52%) and invasiveness/lack of invasiveness was rated as "most important" in 21 (84%). The need for postoperative voiding cystourethrogram was rated as "most important" in 7 (28%) of the cases. Among the 52 cases of open ureteral reimplantation 50 parents (96%) said they would choose the procedure again. Among the 25 endoscopic procedures involving 23 children 3 parents (13%), whose children had a failed endoscopic correction, said they would not choose the procedure again.
Conclusions:
Parents selecting open surgery consider the success of the procedure most important, and the majority are satisfied with their choice of treatment. Parents choosing endoscopic correction consider the minimally invasive nature of the procedure and the success rate most important but the outcome may alter their satisfaction.
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