Delayed-onset ureteral obstruction after endoscopic dextranomer/hyaluronic acid copolymer (Deflux) injection for treatment of vesicoureteral reflux in children: a case series. 2013

Peter C Rubenwolf, and Anne-Karoline Ebert, and Petra Ruemmele, and Wolfgang H Rösch
Department of Pediatric Urology, University Medical Centre Regensburg, Clinic St. Hedwig, Regenburg, Germany. peter.rubenwolf@unimedizin-mainz.de

We report 4 patients with upper urinary tract (UUT) obstruction requiring ureteric reimplantation at 1, 7, 28, and 63 months after dextranomer/hyaluronic acid copolymer (Dx/HA) injection for vesicoureteric reflux. Histopathologic evaluation of ureteric segments revealed extensive foreign body formation in all cases. We conclude that UUT obstruction is a rare but serious complication after Dx/HA injection that can occur even years after surgery. The incidence of delayed-onset UUT obstruction may be higher than previously noted. Long-term follow-up and a critical reappraisal of the method are needed to assess the late sequelae of Dx/HA injection therapy for vesicoureteric reflux.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007267 Injections Introduction of substances into the body using a needle and syringe. Injectables,Injectable,Injection
D003911 Dextrans A group of glucose polymers made by certain bacteria. Dextrans are used therapeutically as plasma volume expanders and anticoagulants. They are also commonly used in biological experimentation and in industry for a wide variety of purposes. Dextran,Dextran 40,Dextran 40000,Dextran 70,Dextran 75,Dextran 80,Dextran B-1355,Dextran B-1355-S,Dextran B1355,Dextran B512,Dextran Derivatives,Dextran M 70,Dextran T 70,Dextran T-40,Dextran T-500,Hemodex,Hyskon,Infukoll,Macrodex,Polyglucin,Promit,Rheodextran,Rheoisodex,Rheomacrodex,Rheopolyglucin,Rondex,Saviosol,Dextran B 1355,Dextran B 1355 S,Dextran T 40,Dextran T 500
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006820 Hyaluronic Acid A natural high-viscosity mucopolysaccharide with alternating beta (1-3) glucuronide and beta (1-4) glucosaminidic bonds. It is found in the UMBILICAL CORD, in VITREOUS BODY and in SYNOVIAL FLUID. A high urinary level is found in PROGERIA. Amo Vitrax,Amvisc,Biolon,Etamucine,Healon,Hyaluronan,Hyaluronate Sodium,Hyvisc,Luronit,Sodium Hyaluronate,Acid, Hyaluronic,Hyaluronate, Sodium,Vitrax, Amo
D013997 Time Factors Elements of limited time intervals, contributing to particular results or situations. Time Series,Factor, Time,Time Factor
D014517 Ureteral Obstruction Blockage in any part of the URETER causing obstruction of urine flow from the kidney to the URINARY BLADDER. The obstruction may be congenital, acquired, unilateral, bilateral, complete, partial, acute, or chronic. Depending on the degree and duration of the obstruction, clinical features vary greatly such as HYDRONEPHROSIS and obstructive nephropathy. Obstruction, Ureteral,Obstructions, Ureteral,Ureteral Obstructions
D014718 Vesico-Ureteral Reflux Retrograde flow of urine from the URINARY BLADDER into the URETER. This is often due to incompetence of the vesicoureteral valve. Primary Vesicoureteral Reflux,Secondary Vesicoureteral Reflux,Vesicoureteral Reflux Grade1,Vesicoureteral Reflux1,Vesicoureteral Reflux,Vesicoureteral Reflux 1,Grade1, Vesicoureteral Reflux,Reflux, Primary Vesicoureteral,Reflux, Secondary Vesicoureteral,Reflux, Vesico-Ureteral,Reflux, Vesicoureteral,Reflux1, Vesicoureteral,Vesico Ureteral Reflux,Vesicoureteral Reflux, Primary,Vesicoureteral Reflux, Secondary,Vesicoureteral Reflux1s
D018666 Ureteroscopy Endoscopic examination, therapy or surgery of the ureter. Surgical Procedures, Ureteroscopic,Ureteroscopic Surgical Procedures,Surgery, Ureteroscopic,Ureteroscopic Surgery,Procedure, Ureteroscopic Surgical,Procedures, Ureteroscopic Surgical,Surgeries, Ureteroscopic,Surgical Procedure, Ureteroscopic,Ureteroscopic Surgeries,Ureteroscopic Surgical Procedure,Ureteroscopies

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