Jae Young Choi; Hyun Tae Kim; Young Hwii Ko; Young Hwan Lee; Phil Hyun Song

doi:10.14777/uti.2016.11.02.62

Journal List > Urogenit Tract Infect > v.11(2) > 1084204

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Choi, Kim, Ko, Lee, and Song: Recurrent Urinary Tract Infection by Bladder Stone Resulting from Subureteral Injection Polydimethylsiloxane (Macroplastique®) for Treatment of Vesicoureteral Reflux

Case Report

Urogenit Tract Infect 2016;11(2):62-65.

Published online: 19 January 2016

DOI: https://doi.org/10.14777/uti.2016.11.02.62

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

Jae Young Choi, Hyun Tae Kim¹, Young Hwii Ko, Young Hwan Lee², Phil Hyun Song

Department of Urology, Yeungnam University College of Medicine, Daegu

¹Department of Urology, Kyungpook National University School of Medicine, Daegu

²Department of Pediatircs, Yeungnam University College of Medicine, Daegu, Korea

Correspondence to: Phil Hyun Song http://orcid.org/0000-0002-3801-258X Department of Urology, Yeungnam University College of Medicine, 170 Hyeonchung-ro, Nam-gu, Daegu 42415, Korea Tel: +82-53-620-3693, Fax: +82-53-627-5535 E-mail: sph04@hanmail.net

Received 28 February 2016 Revised 27 March 2016 Accepted 28 March 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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 late-complication 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.

Keywords: Vesico-ureteral reflux, Subureteral injection, Urinary bladder calculi

REFERENCES

1.van Capelle JW., de Haan T., El Sayed W., Azmy A. The long-term outcome of the endoscopic subureteric implantation of polydimethylsiloxane for treating vesico-ureteric reflux in children: a retrospective analysis of the first 195 consecutive patients in two European centres. BJU Int. 2004. 94:1348–51.

2.Aboutaleb H., Bolduc S., Upadhyay J., Farhat W., Bagli DJ., Khoury AE. Subureteral polydimethylsiloxane injection versus extra-vesical reimplantation for primary low grade vesicoureteral reflux in children: a comparative study. J Urol. 2003. 169:313–6.

3.Elder JS., Diaz M., Caldamone AA., Cendron M., Greenfield S., Hurwitz R, et al. Endoscopic therapy for vesicoureteral reflux: a meta-analysis. I. Reflux resolution and urinary tract infection. J Urol. 2006. 175:716–22.

4.Bae YD., Park MG., Oh MM., Moon DG. Endoscopic subureteral injection for the treatment of vesicoureteral reflux in children: Polydimethylsiloxane (Macroplastique^Ⓡ) versus Dextranomer/Hyaluronic Acid Copolymer (Deflux^Ⓡ). Korean J Urol. 2010. 51:128–31.

5.Capozza N., Caione P. Dextranomer/hyaluronic acid copolymer implantation for vesico-ureteral reflux: a randomized comparison with antibiotic prophylaxis. J Pediatr. 2002. 140:230–4.

6.Solomon LZ., Birch BR., Cooper AJ., Davies CL., Holmes SA. Nonhomologous bioinjectable materials in urology: ‘size matters'? BJU Int. 2000. 85:641–5.

7.Lakgren G., Wahlin N., Skoldenberg E., Stenberg A. Long-term followup of children treated with dextranomer/hyaluronic acid copolymer for vesicoureteral reflux. J Urol. 2001. 166:1887–92.

8.Puri P., Chertin B., Velayudham M., Dass L., Colhoun E. Treatment of vesicoureteral reflux by endoscopic injection of dextranomer/hyaluronic acid copolymer: preliminary results. J Urol. 2003. 170:1541–4.

9.Al-Hunayan AA., Kehinde EO., Elsalam MA., Al-Mukhtar RS. Outcome of endoscopic treatment for vesicoureteral reflux in children using polydimethylsiloxane. J Urol. 2002. 168:2181–3.

10.Smith DP., Kaplan WE., Oyasu R. Evaluation of polydimethylsiloxane as an alternative in the endoscopic treatment of vesicoureteral reflux. J Urol. 1994. 152:1221–4.

Fig. 1.

(A) Ultrasonography revealed a moderate degree hydronephrosis on right kidney. (B) On bladder imaging, 2.0 cm and 1.3 cm sized calcifications were identified around the trigonal area.

Fig. 2.

About 2 cm sized yellowish impacted stone was observed at the site of previous polydimethylsiloxane administration on cystoscopic findings.

Fig. 3.

After cystolitholapaxy, the right ureteral orifice was identified as having a normal shape. The color of urine jetting through the right ureteral orifice was clear.

Fig. 4.

After complete stone removal using cystolitholapaxy, retrograde pyelography was performed to evaluate other cause of ureteral obstruction, showing absence of a filling defect.

TOOLS

Similar articles