Does compliance status predict clinical status in patients undergoing endoscopic management of vesico-ureteral reflux?

Abstract Objective Previous studies of endoscopic management of vesico-ureteral reflux (VUR) have had non-compliance rates around 50%. We examined success rates of patients non-compliant with a delayed follow up protocol after endoscopic injection for VUR. Materials and methods Patients undergoing D...

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Bibliographic Details
Published in:Journal of pediatric urology 2011-12, Vol.7 (6), p.644-649
Main Authors: Kalisvaart, Jonathan F, Scherz, Hal C, Cuda, Scott, Kaye, Jonathan D, Kirsch, Andrew J
Format: Article
Language:English
Subjects:
Adolescent
Child
Child, Preschool
Dextrans - administration & dosage
Dx-HA copolymer
Endoscopy
Female
Humans
Hyaluronic Acid - administration & dosage
Infant
Injections
Male
Patient Compliance
Pediatrics
Prostheses and Implants
Radiography
Urethra - diagnostic imaging
Urinary Bladder - diagnostic imaging
Urology
Vesico-ureteral reflux
Vesico-Ureteral Reflux - diagnostic imaging
Vesico-Ureteral Reflux - therapy
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Summary:Abstract Objective Previous studies of endoscopic management of vesico-ureteral reflux (VUR) have had non-compliance rates around 50%. We examined success rates of patients non-compliant with a delayed follow up protocol after endoscopic injection for VUR. Materials and methods Patients undergoing Double HIT, dextranomer/hyaluronic acid copolymer endoscopic injection for VUR were enrolled in a 1-year, delayed voiding cysto-urethrogram (VCUG) study. All patients non-compliant with the VCUG were contacted and information on their clinical status was collected. Non-compliant patients were re-scheduled for a VCUG. Results 49/54 (91%) patients underwent endoscopic injection for VUR and completed the 6-week ultrasound. At 1-year 49% (24/49) were non-compliant with a VCUG; 75% (18/24) were contacted and provided clinical information. All but one patient agreed to the VCUG. Patients compliant with the 1-year VCUG showed 96% (24/25) clinical and 92% (23/25) radiologic success rates. Non-compliant patients had an 89% (16/18) clinical success rate; 5 (21%) non-compliant patients underwent VCUGs with a 100% success rate. Conclusions Long-term compliance remains an issue for patients treated endoscopically for VUR, but compliance does not predict clinical status as both groups have favorable clinical outcomes. The repeat VCUG is a barrier to long-term follow up as only 21% of patients underwent the study.
ISSN:1477-5131
1873-4898
DOI:10.1016/j.jpurol.2011.03.012