title: Does compliance status predict clinical status in patients undergoing endoscopic management of vesico-ureteral reflux?
abstract: OBJECTIVE
  Previous studies of endoscopic management of vesico-ureteral reflux (VUR) have had non-compliance rates around 50%. We examined success rates of patients non-compliant with a delayed follow up protocol after endoscopic injection for VUR.
  
  
  METHODS
  Patients undergoing Double HIT, dextranomer/hyaluronic acid copolymer endoscopic injection for VUR were enrolled in a 1-year, delayed voiding cysto-urethrogram (VCUG) study. All patients non-compliant with the VCUG were contacted and information on their clinical status was collected. Non-compliant patients were re-scheduled for a VCUG.
  
  
  RESULTS
  49/54 (91%) patients underwent endoscopic injection for VUR and completed the 6-week ultrasound. At 1-year 49% (24/49) were non-compliant with a VCUG; 75% (18/24) were contacted and provided clinical information. All but one patient agreed to the VCUG. Patients compliant with the 1-year VCUG showed 96% (24/25) clinical and 92% (23/25) radiologic success rates. Non-compliant patients had an 89% (16/18) clinical success rate; 5 (21%) non-compliant patients underwent VCUGs with a 100% success rate.
  
  
  CONCLUSIONS
  Long-term compliance remains an issue for patients treated endoscopically for VUR, but compliance does not predict clinical status as both groups have favorable clinical outcomes. The repeat VCUG is a barrier to long-term follow up as only 21% of patients underwent the study.
authors.affiliation: Children's Healthcare of Atlanta, Emory University School of Medicine, Pediatric Urology, Atlanta, GA 30342, USA.
authors.forename: Jonathan F
authors.initials: JF
authors.lastname: Kalisvaart
authors.forename: Hal C
authors.initials: HC
authors.lastname: Scherz
authors.forename: Scott
authors.initials: S
authors.lastname: Cuda
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Kaye
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Kirsch
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003911:Dextrans / Q000008:administration & dosage*; D004724:Endoscopy; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007223:Infant; D007267:Injections; D008297:Male; D010349:Patient Compliance; D019736:Prostheses and Implants; D011859:Radiography; D014521:Urethra / Q000000981:diagnostic imaging; D001743:Urinary Bladder / Q000000981:diagnostic imaging; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging / Q000628:therapy*
chemical_list: D003911:Dextrans; C487487:dextranomer-hyaluronic acid copolymer; D006820:Hyaluronic Acid