Vesicoureteral Reflux Treatment in Children Studied

Procedure choice driven mainly by treating hospital, but other factors play smaller role
By A. Agrawal, PhD
HealthDay Reporter

FRIDAY, Feb. 12 (HealthDay News) -- The treating hospital is the most important factor affecting treatment choice in children with vesicoureteral reflux (VUR), a condition characterized by an abnormal flow of urine from the bladder back into the ureter, according to research published online Feb. 8 in Pediatrics.

Jonathan C. Routh, M.D., of Children's Hospital Boston, and colleagues examined patient- and hospital-associated factors affecting the choice of ureteral reimplantation (UR) or endoscopic injection (EI) in 11,415 children (younger than 18 years old) with primary VUR treated at hospitals offering both procedures.

The researchers found that 51 percent of children underwent UR and 49 percent underwent EI. Children who underwent EI were more commonly older, female, Caucasian, had public insurance, and had less severe disease. This group was also more likely to be treated at larger hospitals, teaching hospitals, or at hospitals in larger metropolitan areas or the South rather than the Northeast. After adjusting for various factors, the treating hospital was the most important variable associated with procedure choice.

"The hospital at which a patient receives treatment is the single most important feature that drove procedure choice for children with primary VUR," the authors conclude. "The patient's age, gender, insurance status, and disease severity played a smaller, although significant, role."

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