Pseudodistal Ureteral Stone Resulting From Calcified Deflux Implantation

• Published in: Urology (Ridgewood, N.J.) Vol. 74; no. 4; pp. 906 - 907
• Main Authors: Polcari, Anthony J, Kim, Dae Y, Helfand, Brian T, Lewis, Jane M, Chaviano, Antonio H
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.10.2009; Elsevier
• Subjects: Biological and medical sciences; Calcinosis - complications; Calcinosis - etiology; Child; Dextrans - adverse effects; Female; Humans; Hyaluronic Acid - adverse effects; Medical sciences; Nephrology. Urinary tract diseases; Prostheses and Implants - adverse effects; Ureteral Calculi - etiology; Urinary lithiasis; Urinary system involvement in other diseases. Miscellaneous; Urinary tract. Prostate gland; Urology; Vesico-Ureteral Reflux - therapy; Ureteral lithiasis; Nephrology; Urinary system disease; Ureteral disease; Implantation; Urinary tract disease; Urology; Urinary stone
• DOI: 10.1016/j.urology.2008.06.018
• ISSN: 0090-4295

Vesicoureteral reflux (VUR) is a common clinical problem affecting 1% of pediatric patients. Subureteral endoscopic injection of dextranomer/hyaluronic acid (Deflux) is a minimally invasive treatment option for VUR that is rapidly gaining popularity. Histologic studies have demonstrated that in a minority of patients, the Deflux injection site can be associated with microcalcification. We report the case of a 12-year-old girl with a history of VUR who had previously been treated with Deflux and presented with abdominal pain and was noted to have a small hyperdense mass in the bladder wall on imaging. The presumptive diagnosis of a distal ureteral stone was ultimately ruled out by cystoscopy and retrograde pyelography, which revealed that the lesion seen on imaging represented the intramural Deflux deposit. This is the second reported case in which a calcified Deflux implant was mistaken for a distal ureteral stone in a patient presenting with abdominal pain.