For pediatric urologist: how often do you recommend a second injection of deflux for bilateral vur f, 4ys. it went down from grade 2 & 4 to 0 & 2.

Minimum 6 months: Minimum 6 months, but does warrant careful regular f/u since the patient is very young, and one side started at Gd 4/5, and was not eliminated by initial/one Deflux injection.

Up to date approach to managing VUR is increasingly conservative. I follow kiids with renal ultrasounds after Deflux injections plus urinalysis & urine culture if & when UTI suspected. No further Deflux would be indicated for 3 year old if US remains normal, which it would with Grade 0 -2 VUR. I would not have repeated the VCUG, which in itself is invasive & very unpleasant. Thus, no repeat Deflux