Distal and late ureteral obstruction: A rare complication following dextranomer/hyaluronic acid injection for vesicoureteral reflux in children

Surgically relevant obstruction after dextranomer/hyaluronic acid injection (Dx/Ha, Deflux (R)) for the treatment of vesicoureteral reflux (VUR) is rare with a 0.6% incidence. It occurs usually during the early postoperative period. We report here the case of a 9-year-old boy with a history of VUR who was previously treated with Deflux (R) and was referred more than 2 years later with acute flank pain (as he already did 2 weeks after surgery with a spontaneous relief under medical treatment). Initial radiological investigations showed hydronephrosis caused by distal ureteral obstruction which required open surgery removal of the Dx/Ha and Cohen procedure. This is the second case of delayed symptomatic obstruction due to Dx/Ha reported in the literature. (C) 2011 Elsevier Masson SAS. All rights reserved.