Ureteral obstruction after dextranomer/hyaluronic acid copolymer injection for treatment of secondary vesicoureteral reflux after renal transplantation

Abstract

Ureteral obstruction after transurethral injection therapy for primary vesicoureteral reflux is known to occur in less than 1% of cases. We report the first case of a ureteral obstruction after transurethral injection of dextranomer/hyaluronic acid copolymer (Deflux) for the treatment of secondary vesicoureteral reflux after renal transplantation. Loss of transplant function made reimplantation of the ureter necessary. A periureteral phlebitis and moderate foreign body reaction was found histologically, although the patient had received immunosuppressive therapy. Endoscopic therapy of secondary vesicoureteral reflux in patients after renal transplantation is a reasonable minimally invasive treatment option; however, severe complications may occur.