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


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.
Schwentner
C
C
Department of Paediatric Urology, Medical University, Anichstr. 35, 6020 Innsbruck, Austria.
Oswald
J
J
Lunacek
A
A
Schlenck
B
B
Pelzer
A E
AE
Schwentner
I
I
Hofer
S
S
Bartsch
G
G
Radmayr
C
C
D019072:Antibiotic Prophylaxis; D002648:Child; D002675:Child, Preschool; D003911:Dextrans / Q000627:therapeutic use*; D004724:Endoscopy; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D008297:Male; D010865:Pilot Projects; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014718:Vesico-Ureteral Reflux / Q000601:surgery*
D003911:Dextrans; C487487:dextranomer-hyaluronic acid copolymer; D006820:Hyaluronic Acid