Health-related quality of life in children with vesicoureteral reflux - impact of successful endoscopic therapy

J Pediatr Urol. 2008 Feb;4(1):20-6. doi: 10.1016/j.jpurol.2007.08.002. Epub 2007 Sep 27.

Abstract

Objectives: Endoscopic therapy for vesicoureteral reflux (VUR) using dextranomer/hyaluronic acid (Dx/HA) has become increasingly popular, but the subjective impact of this therapy and subsequent reflux resolution on health-related quality of life (HRQoL) remains unclear. The aim of this study was to address this issue.

Materials and methods: One hundred children (65 girls, 35 boys; mean age 4.46 years) cured of primary VUR by endoscopic treatment were retrospectively reviewed. The Glasgow children's benefit inventory (GCBI) - a validated, reproducible, post-interventional questionnaire consisting of four subscales - supplemented by sociodemographic and disease-specific questions was employed. The HRQoL benefit was calculated on a scale ranging from -100 (complete failure) to +100 (complete success) and correlated with supplementary data.

Results: Total response rate was 88%. Mean total GCBI score was 28.4+/-20.3 representing a significant HRQoL amelioration. All GCBI subscores improved with the physical health subscale being most relevant. A gender-specific, significant difference in relative GCBI scores was discovered. Correlation with critical life events and time since operation proved the positive effect on HRQoL to be durable.

Conclusions: Resolution of primary VUR secondary to Dx/HA treatment significantly improves HRQoL. HRQoL is positively affected in many areas and not only in those directly associated with VUR. These improvements are not temporary, suggesting that successful Dx/HA therapy may be superior to medical management in terms of children's quality of life.

MeSH terms

  • Antibiotic Prophylaxis
  • Child
  • Child, Preschool
  • Dextrans / therapeutic use*
  • Endoscopy*
  • Female
  • Humans
  • Hyaluronic Acid / therapeutic use*
  • Male
  • Pilot Projects
  • Quality of Life*
  • Retrospective Studies
  • Surveys and Questionnaires
  • Treatment Outcome
  • Vesico-Ureteral Reflux / surgery*

Substances

  • Dextrans
  • dextranomer-hyaluronic acid copolymer
  • Hyaluronic Acid