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Parental preferences in the management of vesicoureteral reflux

Aaron J Krill1, Hans G Pohl, A Barry Belman

  • 1Division of Urology, Children's National Medical Center, Washington, DC, USA. aaronkrill@yahoo.com

The Journal of Urology
|September 28, 2011
PubMed

Insights

Parental preference for managing pediatric vesicoureteral reflux (VUR) initially favors antibiotic prophylaxis. However, preferences shift towards surgical intervention, specifically open surgery, over time for persistent VUR.

Area of Science:

  • Pediatric Urology
  • Nephrology
  • Surgical Management

Background:

  • Vesicoureteral reflux (VUR) management lacks absolute indications for surgical timing and type.
  • Parental input is crucial in decision-making for pediatric VUR treatment.

Purpose of the Study:

  • To objectively measure parental preferences for managing newly diagnosed pediatric vesicoureteral reflux.
  • To assess how parental choices evolve over time and after consultation.

Main Methods:

  • Prospective study of 0-18 year olds with newly diagnosed VUR.
  • Parents viewed an educational video on VUR and treatment options (antibiotic prophylaxis, open ureteral reimplantation, endoscopic treatment).
  • Questionnaires assessed preferences at baseline and hypothetical follow-up points (18, 36, 54 months), followed by blinded urologist consultation.

Main Results:

  • Initial preferences: 35.6% antibiotic prophylaxis, 24.8% endoscopic surgery, 10.4% open surgery, 24.8% unsure.
  • Preferences shifted from antibiotic prophylaxis to endoscopic treatment at 18 months, then towards open surgery at 36 and 54 months.
  • Post-consultation, 68 parents chose antibiotic prophylaxis.

Conclusions:

  • Antibiotic prophylaxis is the initially preferred VUR therapy by a significant portion of parents.
  • Preferences for VUR management evolve, trending towards surgical options with persistent reflux.
  • Long-term preferences show an increasing inclination for open surgery over endoscopic procedures.
Abstract

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