title: Dextranomer-hyaluronic acid implants misdiagnosed as bladder tumor on transvaginal ultrasonography.
abstract: BACKGROUND
  The endoscopic injection of dextranomer-hyaluronic acid has become a popular treatment for childhood vesicoureteral reflux. Treated children are predominantly girls, and many are now entering adulthood. It has been reported in children that the radiographic appearance of implants may lead to misdiagnoses and unnecessary, invasive diagnostic procedures.
  
  
  METHODS
  We report the case of a woman treated with dextranomer-hyaluronic acid for childhood vesicoureteral reflux misdiagnosed with a bladder tumor on transvaginal ultrasonography. Renal ultrasound examination and urinalysis results were normal. Invasive testing was avoided given the history and characteristic ultrasonographic appearance of retained implants.
  
  
  CONCLUSIONS
  It is important for health care providers to be aware of the radiographic appearance of dextranomer-hyaluronic acid implants in adults and to elicit an appropriate past medical history to avoid misdiagnosis and invasive diagnostic procedures.
authors.affiliation: From the Division of Pediatric Urology, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: John J
authors.initials: JJ
authors.lastname: DeCaro
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Kirsch
mesh_terms: D000328:Adult; D003911:Dextrans / Q000627:therapeutic use; D003951:Diagnostic Errors; D019160:Endosonography; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use; D019736:Prostheses and Implants; D001749:Urinary Bladder Neoplasms / Q000000981:diagnostic imaging*; D014718:Vesico-Ureteral Reflux / Q000628:therapy; D055815:Young Adult
chemical_list: D003911:Dextrans; C487487:dextranomer-hyaluronic acid copolymer; D006820:Hyaluronic Acid