Department of Pediatric Urology, University Medical Centre Regensburg, Clinic St. Hedwig, Regenburg, Germany.
Urology. 2013 Mar;81(3):659-62. doi: 10.1016/j.urology.2012.11.044.
We report 4 patients with upper urinary tract (UUT) obstruction requiring ureteric reimplantation at 1, 7, 28, and 63 months after dextranomer/hyaluronic acid copolymer (Dx/HA) injection for vesicoureteric reflux. Histopathologic evaluation of ureteric segments revealed extensive foreign body formation in all cases. We conclude that UUT obstruction is a rare but serious complication after Dx/HA injection that can occur even years after surgery. The incidence of delayed-onset UUT obstruction may be higher than previously noted. Long-term follow-up and a critical reappraisal of the method are needed to assess the late sequelae of Dx/HA injection therapy for vesicoureteric reflux.
我们报告了 4 例患者，他们在接受葡聚糖/透明质酸共聚物（Dx/HA）注射治疗膀胱输尿管反流后 1、7、28 和 63 个月时因上尿路（UUT）梗阻需要进行输尿管再植入术。输尿管节段的组织病理学评估显示所有病例均存在广泛的异物形成。我们得出结论，UUT 梗阻是 Dx/HA 注射后的一种罕见但严重的并发症，甚至在手术后数年也可能发生。迟发性 UUT 梗阻的发生率可能高于先前报道的。需要进行长期随访和对该方法的严格重新评估，以评估 Dx/HA 注射治疗膀胱输尿管反流的后期后果。
