ABSTRACT
Dextranomer/hyaluronic acid (Deflux) has been widely used in the treatment of vesicoureteral
reflux in the pediatric population. It has demonstrated acceptable early efficacy
with minimal morbidity. Early complications from Deflux have been reported to occur
in approximately 1% of cases. However, late complications from Deflux use, including
calcification and delayed ureteral obstruction, are less well understood. We present
the case of an asymptomatic 11 year old girl with severe ipsilateral hydroureteronephrosis,
identified nearly 8 years after treatment. This case details a rare instance of loss
of renal function after Deflux use in a patient with no apparent risk factors.
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References
- Postoperative ureteral obstruction after subureteral injection of dextranomer/hyaluronic acid copolymer.J Urol. 2006; 176 (PMID: 16952696): 1593-1595https://doi.org/10.1016/j.juro.2006.06.101
- Incidence of Deflux® calcification masquerading as distal ureteric calculi on ultrasound.J Pediatr Urol. 2013; 9 (Epub 2012 Nov 24PMID: 23186595): 820-824https://doi.org/10.1016/j.jpurol.2012.10.025
- What is the normal prevalence of vesicoureteral reflux?.Pediatr Radiol. 2000; 30 (PMID: 11009294): 587-593https://doi.org/10.1007/s002470000263
- Intermediate to long-term follow-up indicates low risk of recurrence after double HIT endoscopic treatment for primary vesico-ureteral reflux.J Pediatr Urol. 2012; 8 (Epub 2011 Aug 4. PMID: 21820358): 359-365https://doi.org/10.1016/j.jpurol.2011.07.006
- Complications following endoscopic treatment of vesicoureteric reflux with Deflux(®) - two case studies.Cent Eur J Urol. 2012; 65 (Epub 2012 Dec 11. PMID: 24578970. PMCID: PMC3921807): 230-231https://doi.org/10.5173/ceju.2012.04.art12
- Delayed-onset ureteral obstruction after endoscopic dextranomer/hyaluronic acid copolymer (Deflux) injection for treatment of vesicoureteral reflux in children: a case series.Urology. 2013; 81 (PMID: 23452811): 659-662https://doi.org/10.1016/j.urology.2012.11.044
- Delayed-onset ureteral obstruction and calcification masquerading as renal colic following deflux injection.Urology. 2016; 94 (Epub 2016 Mar 9. PMID: 26970448): 218-220https://doi.org/10.1016/j.urology.2016.03.001
- Ureteral obstruction after endoscopic treatment of vesicoureteral reflux: does the type of injected bulking agent matter?.Curr Urol Rep. 2019; 20 (PMID: 31289951): 49https://doi.org/10.1007/s11934-019-0913-5
- Acute and delayed vesicoureteral obstruction after endoscopic treatment of primary vesicoureteral reflux with dextranomer/hyaluronic acid copolymer: why and how to manage.J Pediatr Urol. 2013; 9 (Epub 2013 Mar 16. PMID: 23507288): 493-497https://doi.org/10.1016/j.jpurol.2013.02.007
- Delayed obstruction with asymptomatic loss of renal function after dextranomer/hyaluronic acid copolymer (deflux) injection for vesicoureteral reflux: a close look at a disturbing outcome.Urology. 2017; 101 (Epub 2016 Sep 26. PMID: 27687330): 63-66https://doi.org/10.1016/j.urology.2016.09.013
- Reoperative ureteroneocystostomy: review of 69 patients.J Urol. 1985; 133 (PMID: 3973988): 388-390https://doi.org/10.1016/s0022-5347(17)48990-7
- Incidence of later ureteral obstruction after antireflux surgery in infants and children.Urology. 1978; 11 (PMID: 628991): 139-141https://doi.org/10.1016/0090-4295(78)90092-4
- Late obstruction after ureteroneocystostomy.J Urol. 1971; 106 (PMID: 5564774): 144-148https://doi.org/10.1016/s0022-5347(17)61244-8
- Late ureteric obstruction following ureteral reimplantation for reflux: a warning.Urology. 1974; 4 (PMID: 4428553): 540-543https://doi.org/10.1016/0090-4295(74)90486-5
- Late post-reimplantation ureteral obstruction during pregnancy: a transient phenomenon?.J Urol. 2003; 170 (PMID: 12913713): 845-848https://doi.org/10.1097/01.ju.0000082688.93786.39
Article info
Publication history
Published online: May 07, 2022
Accepted:
April 24,
2022
Received:
January 29,
2022
Identification
Copyright
Published by Elsevier Inc.