RESULTS OF A VESICOURETERAL REFLUX PRACTICE PATTERN SURVEY AMONG AMERICAN-ACADEMY-OF-PEDIATRICS, SECTION ON PEDIATRIC UROLOGY MEMBERS

Purpose: We evaluated practice patterns among urologists managing vesi coureteral reflux, and identified areas of consensus and controversy r equiring further research. Materials and Methods: A 1-page questionnai re addressing various aspects of reflux management, including screenin g, diagnosis, treatment and followup, was mailed to a cohort of 225 pr acticing urologists identified by the membership roster of the America n Academy of Pediatrics, Section on Pediatric Urology. Coded returned mailers were blindly analyzed and tabulated by 2 reviewers. Questionna ires were subdivided using a coding system by decade (1970s or earlier , 1980s and so forth) of participant membership in the American Urolog ical Association. Select questions were analyzed to determine whether time of training affected the response. Results: Of 225 surveys 155 we re returned and usable (overall 60.8% response rate). General agreemen t exists regarding several important points in the management of vesic oureteral reflux, including evaluation of patients at the initial urin ary tract infection (78.1% of respondents), use of voiding cystourethr ography and ultrasound at the initial evaluation (99.4 and 96.8%, resp ectively), and evaluation of sibling reflux (83.2%). Certain absolute and relative indications for surgical intervention require further cla rification. Various reimplantation techniques are used today, stents a re not placed by the majority of practitioners and significant variati ons exist in the duration of postoperative hospital stay. Conclusions: Today there is substantial consensus among urologists on many issues regarding vesicoureteral reflux management. However, the areas of cont roversy will only be clarified by further scientific and clinical outc omes based research.