“The personal preferences of parents (and, at older ages, patients) must be considered in weighing the benefits and harms of treatment options.”
American Urological Association Clinical Practice Guidelines1
In a survey that questioned 91 families of children with various grades of vesicoureteral reflux (VUR) about their treatment preferences;
In another study, the parents of 100 children with grade III VUR were fully informed about three treatment options for VUR:
It was explained that antibiotic prophylaxis is a preventative measure and does not cure VUR but avoids more invasive procedures. A cure rate of >95% was quoted for open surgery, compared with 70% for endoscopic treatment along with the advantage that complications are rare with endoscopic treatment. Based on the information presented, parents’ responses to a questionnaire showed:
80% of parents surveyed preferred endoscopic treatment rather than antibiotic prophylaxis or open surgery.
Taking into account the VUR treatment options preferred by parents of children with grade III VUR, investigators proposed a treatment algorithm with endoscopic treatment as first-line treatment for persistent VUR.
Open surgery is recommended for severe cases or those who have failed endoscopic treatment.3
Safety and efficacy of treatment of duplex systems, use of more than 6 mL of Deflux (3 mL at each ureteral orifice) at the same treatment session, and treatment of children under 1 year of age have not been established.