Clinical practice in vesicoureteral reflux with respect to EAU guidelines: A multicenter study

Area of Science:

• Urology
• Pediatric Surgery
• Medical Guidelines

Background:

• Vesicoureteral reflux (VUR) is a significant condition requiring appropriate management.
• The European Association of Urology (EAU) provides established guidelines for VUR treatment.
• Adherence to these guidelines is crucial for optimizing patient outcomes.

Purpose of the Study:

• To investigate current trends in the initial management of VUR.
• To assess the alignment of clinical practice with EAU Guidelines on VUR.
• To analyze management strategies across different risk groups and time periods.

Main Methods:

• A multicenter, retrospective study involving 1988 renal units from 1345 patients treated between 2003 and 2017.
• Patients were categorized by initial treatment (conservative vs. surgical) and risk factors according to EAU guidelines.
• Data analysis focused on treatment trends and surgical success rates before and after 2013.

Main Results:

• Initially conservative management was more common (1426 RUs) than surgical (562 RUs).
• Surgical success rates decreased significantly in low and moderate risk groups after 2013.
• Initial surgical treatment increased significantly in moderate and high-risk groups post-2013, despite declining success rates.

Conclusions:

• Current VUR management practices in the country do not fully adhere to EAU guidelines, especially for low and moderate risk patients.
• Despite the availability of reliable guidelines, clinical approaches have not consistently followed them.
• Further efforts are needed to promote guideline-based VUR management.