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Parental experiences and preferences regarding the treatment of vesicoureteral reflux.

Journal article
Authors Tryggve Nevéus
Per Brandström
Tina Linnér
Ulf Jodal
Sverker Hansson
Published in Scandinavian journal of urology and nephrology
Volume 46
Issue 1
Pages 26-30
ISSN 1651-2065
Publication year 2012
Published at Institute of Clinical Sciences, Department of Pediatrics
Pages 26-30
Language en
Subject categories Pediatric surgery, Pediatrics


Abstract Objective. Dilating vesicoureteral reflux (VUR) has been linked to febrile urinary tract infection (UTI) and renal scarring. It is unclear, however, whether children with reflux should be treated surgically or medically, or just kept under close surveillance with prompt treatment of UTIs. This lack of evidence makes parental preferences a crucial factor in the choice of therapy. The Swedish Reflux Trial was set up to compare the three treatment alternatives prospectively. This paper focuses on parental experience and satisfaction after completing the trial. Material and methods. A group of 203 children aged 12-24 months with reflux grade III or IV were randomly assigned to antibiotic prophylaxis (n = 69), surveillance (n = 68) or endoscopic injection treatment (n = 66) and followed closely for 2 years. Afterwards, the families were interviewed by an investigator not involved in the care of the children about their experience of the study. Results. Parental satisfaction with the treatment given was high, with 53% scoring 5 and 35% 4 on a five-grade scale, with no difference between the three groups (p = 0.5). Recurrence of febrile UTI or new kidney scarring did not influence parental satisfaction. Even though the satisfaction was high regardless of therapy, parents of children in the prophylaxis group more often than others would have chosen another treatment if given a choice. Conclusions. As far as parental satisfaction and preferences are concerned, antibiotic prophylaxis, surveillance and injection treatment are equivalent treatment strategies in children with VUR.

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