Factors involved in parental decision making for surgical correction of vesicoureteral reflux.

Abstract

Surgical management of vesicoureteral reflux has changed with the use of endoscopic correction. We evaluated the possible factors that may affect parental decision making with regard to this procedure, and assessed subsequent parent satisfaction. We retrospectively reviewed the records of patients who underwent surgery for vesicoureteral reflux during a 3-year period. We used a telephone based survey, rating factors affecting decision making and overall satisfaction. A total of 74 parents of children 1.5 to 18 years old participated in the study, and 77 procedures were evaluated. Among the 52 cases of open reimplantation success was rated as "most important" in 47 (90.4%) and long-term history was rated as "most important" in 30 (57.7%). Among the 25 cases of endoscopic correction success was rated as "most important" in 13 (52%) and invasiveness/lack of invasiveness was rated as "most important" in 21 (84%). The need for postoperative voiding cystourethrogram was rated as "most important" in 7 (28%) of the cases. Among the 52 cases of open ureteral reimplantation 50 parents (96%) said they would choose the procedure again. Among the 25 endoscopic procedures involving 23 children 3 parents (13%), whose children had a failed endoscopic correction, said they would not choose the procedure again. Parents selecting open surgery consider the success of the procedure most important, and the majority are satisfied with their choice of treatment. Parents choosing endoscopic correction consider the minimally invasive nature of the procedure and the success rate most important but the outcome may alter their satisfaction.