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• W1966767369 abstract "You have accessJournal of UrologyPediatrics: Urinary Tract Infection/Vesicoureteral Reflux1 Apr 2013655 A DECADE OF PRIMARY VESICOURETERAL REFLUX MANAGEMENT IN THE ERA OF DEXTRANOMER/HYALURONIC ACID Katherine W. Herbst, Sean T. Corbett, Thomas S. Lendvay, and Anthony A Caldamone Katherine W. HerbstKatherine W. Herbst Hartford, CT More articles by this author , Sean T. CorbettSean T. Corbett Charlottesville, VA More articles by this author , Thomas S. LendvayThomas S. Lendvay Seattle, WA More articles by this author , and Anthony A CaldamoneAnthony A Caldamone Providence, RI More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.208AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES A study published by Lendvay et. al. reported a dramatic increase in the use of dextranomer/hyaluronic acid (DxHA) injection therapy for vesicoureteral reflux (VUR) in the United States between 2002 and 2004. Our objective was to determine if this increase in DxHA utilization was sustained through the decade. METHODS Data on pediatric patients receiving ureteral reimplantation or DxHA intervention for primary VUR from 2004 to 2011 was abstracted from the Pediatric Health Information System (PHIS) database. Patients with coding data indicating diagnoses other than primary VUR, and hospitals (by year) reporting less than 80% of ambulatory surgery cases with a CPT Code were excluded. Linear regression was used to analyze institutional mean number of procedures by year for trend during the study period, and t-tests were applied to compare means between years. RESULTS We identified 14,430 patients, 17,826 procedures, 49% of whom received reimplantation and 51% DxHA. The majority of patients were female (83%) with a median age at surgery of 4.75 years. Regression showed a significant downward trend in total antireflux surgery institutional mean over the study period (r2=0.58, p < 0.05), which we attributed to a decrease in mean rates of DxHA interventions (r2=0.64, p < 0.05), as mean rates for reimplantation remained stable during this time (r2 <0.001, p = 0.95). The rate of DxHA rose from 2004 to 2006, peaking at an annual institutional mean of 50 procedures, and then declined to a mean of 29 in 2011 (Fig1). In 2006, 63% of hospitals were performing more DxHA procedures than reimplantations. As rates of DxHA procedures declined, this proportion was reversed, and by 2008 the majority of hospitals were performing more reimplantations than DxHA injections. CONCLUSIONS Using the PHIS database, there is a trend towards decreasing intervention for primary VUR which appears to be due to reduced usage of injection therapy. This may reflect a philosophical change in reflux management for those grades of reflux treated by injection therapy. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e268 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Katherine W. Herbst Hartford, CT More articles by this author Sean T. Corbett Charlottesville, VA More articles by this author Thomas S. Lendvay Seattle, WA More articles by this author Anthony A Caldamone Providence, RI More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W1966767369 title "655 A DECADE OF PRIMARY VESICOURETERAL REFLUX MANAGEMENT IN THE ERA OF DEXTRANOMER/HYALURONIC ACID" @default.
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