Giant foreign body granuloma after endoscopic management of vesicoureteric reflux: a case report

Abstract Background Deflux®, a dextranomer/hyaluronic acid copolymer, is extensively used as an endoscopic bulking agent for management of vesicoureteric reflux (VUR). The complications following Deflux® treatment as described in the literature are clinically insignificant transient obstruction and...

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Main Authors: Saket Davera (Author), Anjan Dhua (Author), Shipra Agarwal (Author), Mohamed Sulaiman (Author)
Format: Book
Published: SpringerOpen, 2022-12-01T00:00:00Z.
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Summary:Abstract Background Deflux®, a dextranomer/hyaluronic acid copolymer, is extensively used as an endoscopic bulking agent for management of vesicoureteric reflux (VUR). The complications following Deflux® treatment as described in the literature are clinically insignificant transient obstruction and infections of the urinary tract. We report a rare case of a giant Deflux® granuloma presenting as an intraoperative surprise while undergoing open ureteric reimplantation for the failure of prior endoscopic management. Case presentation A 2.5-year-old boy with a primary VUR needed Anderson Hyne's pyeloplasty of the affected side for concomitant pelviureteric junction obstruction. During removal of the double "J "stent in the postoperative period, subureteric Deflux® was injected, hoping that a more invasive procedure could be avoided. At a later date, as VUR persisted, an open ureteric reimplantation, was performed. Intraoperatively, a large Deflux® granuloma was noted at the site of previously injected site. Conclusions Giant Deflux® granuloma is a rare complication of this modality of VUR management. A focussed radiological assessment in such pateints during follow-up is required, especially those planned for surgical intervention in the vesicoureteric region later.
Item Description:10.1186/s43159-022-00220-0
2090-5394