MP61-08 VOIDING CYSTOURETHROGRAM AND ANTIBIOTIC PROPHYLAXIS FOR PRENATAL HYDRONEPHROSIS: SURPRISING RESULTS FROM A SURVEY OF SFU MEMBERS’ PRACTICE PATTERNS

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You have accessJournal of UrologyPediatrics: Urinary Tract Infection and Vesicoureteral Reflux1 Apr 2017MP61-08 VOIDING CYSTOURETHROGRAM AND ANTIBIOTIC PROPHYLAXIS FOR PRENATAL HYDRONEPHROSIS: SURPRISING RESULTS FROM A SURVEY OF SFU MEMBERS’ PRACTICE PATTERNS Adriana Dekirmendjian, Mandy Rickard, CD Anthony Herndon, Christopher S. Cooper, Armando J. Lorenzo, Bethany Easterbrook, Rebecca S. Zee, Natasha Brownrigg, and Luis H. Braga Adriana DekirmendjianAdriana Dekirmendjian More articles by this author , Mandy RickardMandy Rickard More articles by this author , CD Anthony HerndonCD Anthony Herndon More articles by this author , Christopher S. CooperChristopher S. Cooper More articles by this author , Armando J. LorenzoArmando J. Lorenzo More articles by this author , Bethany EasterbrookBethany Easterbrook More articles by this author , Rebecca S. ZeeRebecca S. Zee More articles by this author , Natasha BrownriggNatasha Brownrigg More articles by this author , and Luis H. BragaLuis H. Braga More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1866AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Voiding cystourethrogram (VCUG) may be ordered in infants during workup of prenatal hydronephrosis (HN) or after febrile urinary tract infection (fUTI). Definitive guidelines regarding VCUG indications and prescription of continuous antibiotic prophylaxis (CAP) are lacking, resulting in a diverse clinical practice. This study aimed to explore current practice patterns amongst pediatric urologists. METHODS An online survey was distributed to members of the Society for Fetal Urology (SFU) to assess practice patterns surrounding VCUG and CAP use in infants. To ensure face and content validity, the survey was developed by experts in the field and piloted locally. Anonymized responses were analyzed according to HN etiology (isolated HN vs. hydroureteronephrosis [HUN]) and grade (low vs. high SFU), gender and circumcision status, as well as the use of antibiotics for prevention of post-VCUG UTI. RESULTS Response rate was 37% (109/297), with 86 (79%) respondents coming from an academic setting. No difference was observed regarding use of CAP or VCUG indications for unilateral vs. bilateral HN or between genders/circumcision status. In contrast, regardless of HN etiology and gender, an expected difference in CAP use was observed between low grade HN (SFU I/II) vs. high grade HN (SFU III/IV) (p<0.001). Most respondents recommended CAP and VCUG to infants with high grade HUN (Table 1). For infants with their 1st fUTI and a normal ultrasound (US), we observed that more respondents would order VCUG for males (74%) and females (77%) 0-2 mos. compared to male (54%) and female (53%) infants 2-24 mos. (p<0.01). No significant difference was found when comparing VCUG indications for a 1st fUTI for male and female infants 0-2 and 2-24 mos. with abnormal US. Over 90% of respondents indicated that they would order VCUG regardless of gender or age for this cohort. Despite 85% of clinicians reporting that they had observed a UTI after VCUG, only 31 (28%) empirically treated to avoid a potential post-VCUG UTI. CONCLUSIONS This is the largest study to date assessing pediatric urology practice patterns in evaluating subtypes of prenatal HN. Despite being a common condition, our study demonstrates VCUG and CAP practice patterns vary substantially. Surprisingly, CAP use and VCUG indications were minimally affected by gender and HN laterality. However, their use was much more common in infants with high vs. low grade HN, as well as those with HUN compared to isolated HN. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e801-e802 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Adriana Dekirmendjian More articles by this author Mandy Rickard More articles by this author CD Anthony Herndon More articles by this author Christopher S. Cooper More articles by this author Armando J. Lorenzo More articles by this author Bethany Easterbrook More articles by this author Rebecca S. Zee More articles by this author Natasha Brownrigg More articles by this author Luis H. Braga More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

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