Schwentner C et al. (2008) Health-related quality of life in children with vesicoureteral reflux—impact of successful endoscopic therapy. J Pediatr Urol 4: 20–26

Endoscopic dextranomer–hyaluronic acid copolymer (DHA) injection is an effective alterative to long-term antibiotic prophylaxis or open surgery for the treatment of vesicouretal reflux (VUR) in children. Nevertheless, the health-related quality of life (HRQOL) benefit of successful endoscopic treatment with DHA is not known; in a new study, Schwentner and colleagues assessed this benefit in a pediatric cohort.

Their retrospective, pilot study included 100 children (mean age 4.46 years; 65 girls) cured of VUR by endoscopic DHA treatment. The Glasgow Children's Benefit Inventory (GCBI) questionnaire—which scores the HRQOL benefits of an intervention on an overall scale from −100 (maximum harm) to +100 (maximum benefit)—was mailed to patients at a mean of 2.16 ± 1.34 years after treatment, and 88 parent-completed responses were returned.

Successful treatment had a positive effect on the children's HRQOL (mean total GCBI score 28.4 ± 20.3); the reported benefits were sustained and independent of critical life events. HRQOL improvement was seen on all four GCBI subscales (emotion, physical health, learning and vitality). Interestingly, sex-specific total GCBI score and GCBI subscores for emotion, vitality and learning indicated that girls benefited more than boys.

The study found that many areas of the children's lives were improved by successful endoscopic treatment for VUR; however, the authors concede that prospective studies are needed to compare the benefits of endoscopic DHA injection with those of other treatments.