title: Late ureteral obstruction after injection of dextranomer/hyaluronic acid copolymer.
abstract: Various biological and artificial materials have been introduced for endoscopic treatment of vesicoureteral reflux. Over the past years, dextranomer combined with hyaluronic acid (Dx/Ha) has been established as the most commonly used tissue-augmenting substance for subureteral injection because of its biocompatibility. Nevertheless, the histopathologic analysis of failed Dx/Ha injections showed changes in consistency and volume of the deposit and granulomatous reactions of the adjacent tissue. We report a case of late-onset obstruction 2 years after the injection of Dx/Ha. In the current literature, this potential long-term complication is hardly mentioned.
authors.affiliation: Department of Pediatric Urology, University Children's Hospital Zurich, Zurich, Switzerland. Electronic address: samuelchristen@gmail.com.
authors.forename: Samuel
authors.initials: S
authors.lastname: Christen
authors.affiliation: Department of Pediatric Surgery, Regional Hospital Bellinzona, Switzerland.
authors.forename: Mario
authors.initials: M
authors.lastname: Mendoza
authors.affiliation: Department of Pediatric Urology, University Children's Hospital Zurich, Zurich, Switzerland.
authors.forename: Rita
authors.initials: R
authors.lastname: Gobet
authors.affiliation: Department of Pathology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Peter
authors.initials: P
authors.lastname: Bode
authors.affiliation: Department of Pediatric Urology, University Children's Hospital Zurich, Zurich, Switzerland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Weber
mesh_terms: D001672:Biocompatible Materials / Q000737:chemistry; D002114:Calcinosis / Q000601:surgery; D002675:Child, Preschool; D003911:Dextrans / Q000009:adverse effects*; D004724:Endoscopy; D005260:Female; D005355:Fibrosis / Q000473:pathology; D005549:Foreign-Body Reaction; D006801:Humans; D006820:Hyaluronic Acid / Q000009:adverse effects*; D006869:Hydronephrosis / Q000628:therapy; D011475:Prosthesis Failure; D019919:Prosthesis Implantation; D011704:Pyelonephritis / Q000175:diagnosis / Q000209:etiology; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000209:etiology*; D014552:Urinary Tract Infections / Q000628:therapy; D014718:Vesico-Ureteral Reflux / Q000628:therapy*
chemical_list: D001672:Biocompatible Materials; D003911:Dextrans; C487487:dextranomer-hyaluronic acid copolymer; D006820:Hyaluronic Acid