Delayed onset ureteral obstruction following Deflux® injection for vesicoureteral reflux

Zemple, Robert P.; Potretzke, Aaron M.; Kryger, John V.

doi:10.1016/j.jpurol.2011.12.007

Cited by 16 publications

(3 citation statements)

References 10 publications

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“…In addition to late recurrence of VUR, an increasing number of early and delayed ureteral obstructions have been reported, although the incidence was still lower than the rate associated with open surgery [62636465]. Most cases of ureteral obstruction were resolved after temporary double-J stenting [65], but some required open ureteral reimplantation because of inflammatory foreign body reaction [6266].…”

Section: Current Trend and Debates On Endoscopic Injectionmentioning

confidence: 99%

Endoscopic injection therapy

Kim

Lee

2017

Investig Clin Urol

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Since the U.S. Food and Drug Administration approved dextranomer/hyaluronic acid copolymer (Deflux) for the treatment of vesicoureteral reflux, endoscopic injection therapy using Deflux has become a popular alternative to open surgery and continuous antibiotic prophylaxis. Endoscopic correction with Deflux is minimally invasive, well tolerated, and provides cure rates approaching those of open surgery (i.e., approximately 80% in several studies). However, in recent years a less stringent approach to evaluating urinary tract infections (UTIs) and concerns about long-term efficacy and complications associated with endoscopic injection have limited the use of this therapy. In addition, there is little evidence supporting the efficacy of endoscopic injection therapy in preventing UTIs and vesicoureteral reflux-related renal scarring. In this report, we reviewed the current literature regarding endoscopic injection therapy and provided an updated overview of this topic.

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Section: Current Trend and Debates On Endoscopic Injectionmentioning

confidence: 99%

Endoscopic injection therapy

Kim

Lee

2017

Investig Clin Urol

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“…Ureteral obstruction remains a rare complication after endoscopic correction of VUR, generally reported in less than 1% of treated cases, which appears to be independent of the injected substance, volume, and technique [ 90 ]. However, long-term follow-up (5 years) is recommended as asymptomatic or delayed obstruction can occur, potentially leading to loss of renal function [ 91 ].…”

Section: Resultsmentioning

confidence: 99%

Endoscopic injection of bulking agents in pediatric vesicoureteral reflux: a narrative review of the literature

et al. 2023

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In the last 20 years, endoscopic injection (EI) has affirmed as a valid alternative to open surgery for management of pediatric vesicoureteral reflux (VUR). This study aimed to investigate and discuss some debated aspects such as indications, bulking agents and comparison, techniques of injection and comparison, predictive factors of success, use in specific situations. EI is minimally invasive, well accepted by patients and families, with short learning curve and low-morbidity profile. It provides reflux resolution rates approaching those of open reimplantation, ranging from 69 to 100%. Obviously, the success rate may be influenced by several factors. Recently, it is adopted as first-line therapy also in high grade reflux or complex anatomy such as duplex, bladder diverticula, ectopic ureters. The two most used materials for injection are Deflux and Vantris. The first is absorbable, easier to inject, has lower risk of obstruction, but can lose efficacy over time. The second is non-absorbable, more difficult to inject, has higher risk of obstruction, but it is potentially more durable. The two main techniques are STING and HIT. To date, the ideal material and technique of injection has not yet clearly established, but the choice remains dependent on surgeon’s preference and experience.

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“…The common denominator in all reports of delayed obstruction is a marked FBR at the obstructed ureteral orifice and all cases were corrected by surgery. 12,13 In these reports, the interval between STING and detection of obstruction was 1 to 62 months. 13,14 Our patient had normal non-dilated left upper tract 2 years after STING.…”

Section: Discussionmentioning

confidence: 98%

Late ureteral obstruction in an adult who had STING/Teflon in childhood: Should we expect an epidemic?

Rosenberg

Lorber

Landau

et al. 2015

CUAJ

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We present a case of left renal colic in a 25-year-old female patient. She had subureteral injection of Teflon (STING) at the age of 10 due to vesico-ureteral reflux (VUR) disease and recurrent urinary tract infections. Renal colic was the result of late ureteral obstruction due to Teflon-induced periureteral foreign body reaction. To our knowledge, this is the longest interval between STING and ureteral obstruction reported and the first case of delayed ureteral obstruction caused by Teflon. Monitoring the upper tracts of patients after STING should go beyond childhood.

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Delayed onset ureteral obstruction following Deflux® injection for vesicoureteral reflux

Cited by 16 publications

References 10 publications

Endoscopic injection therapy

Endoscopic injection therapy

Endoscopic injection of bulking agents in pediatric vesicoureteral reflux: a narrative review of the literature

Late ureteral obstruction in an adult who had STING/Teflon in childhood: Should we expect an epidemic?

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