title: Delayed-onset ureteral obstruction after endoscopic dextranomer/hyaluronic acid copolymer (Deflux) injection for treatment of vesicoureteral reflux in children: a case series.
abstract: 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.
authors: Department of Pediatric Urology, University Medical Centre Regensburg, Clinic St. Hedwig, Regenburg, Germany. peter.rubenwolf@unimedizin-mainz.de
authors: Peter C
authors: PC
authors: Rubenwolf
authors: Anne-Karoline
authors: AK
authors: Ebert
authors: Petra
authors: P
authors: Ruemmele
authors: Wolfgang H
authors: WH
authors: Rösch
mesh_terms: D003911:Dextrans / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000009:adverse effects*; D007223:Infant; D007267:Injections; D013997:Time Factors; D014517:Ureteral Obstruction / Q000209:etiology*; D018666:Ureteroscopy; D014718:Vesico-Ureteral Reflux / Q000628:therapy*
chemical_list: D003911:Dextrans; C094535:deflux; C487487:dextranomer-hyaluronic acid copolymer; D006820:Hyaluronic Acid