617 EROSION OF CALCIFIED MARCROPLASTIQUE: A LATE COMPLICATION FOLLOWING INJECTION FOR VESICO-URETERAL REFLUX

Abstract

You have accessJournal of UrologyPediatrics: Imaging (Genital & Urinary Tract)/Infections and Vesicoureteral Reflux1 Apr 2012617 EROSION OF CALCIFIED MARCROPLASTIQUE: A LATE COMPLICATION FOLLOWING INJECTION FOR VESICO-URETERAL REFLUX Justin Lee, Bryce Weber, Victor Figueroa, Rodrigo Romao, Joao L. Pippi Salle, Darius Bagli, Antoine Khoury, and Armando Lorenzo Justin LeeJustin Lee Toronto, Canada More articles by this author , Bryce WeberBryce Weber Toronto, Canada More articles by this author , Victor FigueroaVictor Figueroa Toronto, Canada More articles by this author , Rodrigo RomaoRodrigo Romao Toronto, Canada More articles by this author , Joao L. Pippi SalleJoao L. Pippi Salle Toronto, Canada More articles by this author , Darius BagliDarius Bagli Toronto, Canada More articles by this author , Antoine KhouryAntoine Khoury Orange, CA More articles by this author , and Armando LorenzoArmando Lorenzo Toronto, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.695AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Polydimethylsiloxane (Macroplastique®) gained acceptance in many parts of the world as an injectable bulking agent for correction of vesicoureteral reflux (VUR). Although regarded as safe and effective, the long-term consequences of such intervention remain largely unknown. Herein we report one important complication detected during follow-up in a single institution series. METHODS A total of 274 children underwent subureteric injection between 1998 and 2004, being regularly monitored since. Of these, all patients that have presented with submucosal calcification in the prior area of injection have been prospectively captured. Clinical features and data on patient characteristics were obtained by chart review. RESULTS Four patients ages 10, 13, 13 and 15 developed submucosal bladder calcifications 5, 7, 9, and 10 years following the initial injection for VUR. In all, the intervention was uneventful and no clinical or sonographic abnormalities were detected after the procedure. Patients subsequently presented with worsening hydronephrosis, hematuria and irritative lower urinary tract symptoms. On ultrasonography and X-ray we discovered calcifications at the site of prior injection. At time of surgery the calcified material was extracted endoscopically after unroofing the overlying eroded mucosa or resected along with its adjacent fibrotic pseudo-capsule through cystotomy. To date no recurrences have been detected and none of the patients have undergone ureteral reimplantation. CONCLUSIONS This experience calls attention to a potentially important yet rare complication that can be encountered following endoscopic injection with Macroplastique®. Monitoring of these patients appears warranted as long-term issues with new injectable materials remains largely unknown. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e251 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Justin Lee Toronto, Canada More articles by this author Bryce Weber Toronto, Canada More articles by this author Victor Figueroa Toronto, Canada More articles by this author Rodrigo Romao Toronto, Canada More articles by this author Joao L. Pippi Salle Toronto, Canada More articles by this author Darius Bagli Toronto, Canada More articles by this author Antoine Khoury Orange, CA More articles by this author Armando Lorenzo Toronto, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...