Recurrent Urinary Tract Infection by Bladder Stone Resulting from Subureteral Injection Polydimethylsiloxane (Macroplastique®) for Treatment of Vesicoureteral Reflux

Abstract

While endoscopic subureteral injection of bulking agents has become a first-line therapy for the treatment of vesicoureteral reflux (VUR), mainly due to its high success rates with minimal complications, polydimethylsiloxane (PDS) administration can be associated with bladder calcification in a minority of patients. A 10-year-old girl with prior history of subureteral administration of PDS as a treatment modality for bilateral VUR six years ago showed recurrent lower urinary tract symptoms, including dysuria, frequency, and urgency, for the past 6 months. She was admitted to our institution for right pyelonephritis with hydronephrosis. Radiologic examination had revealed two yellowish impacted stones attached to the previous site of PDS administration without recurrence of VUR. The stones were completely removed by cystolitholapaxy. This study suggests that such a latecomplication should be considered in patients with recurrent urinary tract infection or lower urinary tract symptom despite complete disappearance of VUR by prior subureteral administration therapy.

Submucosal stone formation after 14-years of polydimethylsiloxane (Macroplastique®) endoscopic subureteric injection for vesicoureteral reflux: Unusual presentation for a rare complication

“… 3 Macroplastique® is a silicon elastomer with widespread medical applications, such as pacemaker leads, artificial urinary sphincter, and others. 1 STING with Macroplastique® has acquired acceptance and popularity due to the material's effectiveness and safety. 1 …”

“… 1 STING with Macroplastique® has acquired acceptance and popularity due to the material's effectiveness and safety. 1 …”

“…Vesicoureteral reflux (VUR) affects 50% of children with urinary tract infection (UTI). 1 A UTI contributes to renal function deterioration and affects the overall health of a child. 2 Treatment options include both medical and surgical therapies.…”

“…Different materials are available for subureteric implantation. 1 , 2 , 3 Macroplastique® gained popularity for VUR correction, although it has not yet been approved by the Food and Drug Administration (FDA). In this study, we report a case of unusual delayed presentation in the form of microscopic hematuria caused by calcified Macroplastique® after 14-years.…”

Calcified Macroplastique Substance: A Rare Cause of Recurrent Gross Hematuria after Endoscopic Injection

“…US revealed two bladder stones (2.0 cm and 1.3 cm) near the right trigonal area of the bladder, 6 years after the endoscopic injection. Complete stone re moval using cystolitholapaxy was performed 10) . In another study, a 38yearold male patient who had undergone Ma croplastique injection 7 years ago due to VUR, had left sided abdominal pain.…”