title: Practice patterns among pediatric urologists in the use of Deflux® for vesicoureteral reflux: a survey.
abstract: OBJECTIVE
  This study aims to assess pediatric urology practice patterns and factors which influence the use of Deflux(®) in the management of vesicoureteral reflux among pediatric urologists.
  
  
  METHODS
  A 11-question survey was sent out to 476 pediatric urologists who are members of the Society for Pediatric Urology.
  
  
  RESULTS
  23.7% of pediatric urologists use Deflux(®) as first line therapy for Grade III reflux or higher. The presence of renal scarring is not a deterrent to the use of Deflux(®). 17.7% would use Deflux(®) before a trial of observation with or without chemoprophylaxis. In children who are on observation, 20.3% would perform Deflux(®) when they are at an age considered appropriate for surgery as opposed to continued observation. The majority of pediatric urologists cite Deflux(®) success rates of >70% to >80% for Grades II-III and >50% to >60% for Grades IV-V. 23.3% of respondents indicated that new evidence citing low long-term success rates at one year decreased their use of Deflux(®). 59.8% of respondents indicated they would perform a second injection after an initial failure. Ultrasound and VCUG are used as follow-up in 86.9% and 65.4% respectively after Deflux(®); the majority are performed within the first 3 months, rarely at one year.
  
  
  CONCLUSIONS
  The use of Deflux(®) is growing and whether it surpasses open reimplantation and chemoprophylaxis as first-line therapy remains to be seen. With new literature showing lower success rates, long-term follow-up with repeat imaging may be required.
authors: UMDNJ-New Jersey Medical School, Department of Urology, 140 Bergen Street, Suite G, Newark, NJ 07103, USA. Electronic address: ginacambareri@gmail.com.
authors: Gina M
authors: GM
authors: Cambareri
authors: Moneer K
authors: MK
authors: Hanna
authors: Jeffrey A
authors: JA
authors: Stock
mesh_terms: D002648:Child; D003911:Dextrans / Q000627:therapeutic use*; D019538:Health Care Surveys; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D007267:Injections; D010372:Pediatrics; D011364:Professional Practice; D019736:Prostheses and Implants; D019233:Retreatment; D016896:Treatment Outcome; D014572:Urology; D014718:Vesico-Ureteral Reflux / Q000601:surgery / Q000628:therapy*
chemical_list: D003911:Dextrans; C094535:deflux; D006820:Hyaluronic Acid
keywords: Deflux(®); Pediatric urology; Practice patterns; Survey; Vesicoureteral reflux