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

Children's Healthcare of Atlanta, Emory University School of Medicine, Pediatric Urology, 5445 Meridian Mark Rd, Atlanta, GA 30342, USA.

 

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.

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.

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.

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.

Written by:
Kalisvaart JF, Scherz HC, Cuda S, Kaye JD, Kirsch AJ.   Are you the author?

Reference: J Pediatr Urol. 2011 Apr 28. Epub ahead of print.
doi: 10.1016/j.jpurol.2011.03.012

PubMed Abstract
PMID: 21531176

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