Incidence of Deflux® calcification masquerading as distal ureteric calculi on ultrasound
Abstract Objective Dextranomer-hyaluronic acid (Deflux® ), the most widely used compound in the endoscopic treatment of vesico-ureteric reflux (VUR) today, is believed to provoke only minimal inflammation. Reports of calcification of Deflux® are increasing. We ascertain the incidence of Deflux® calc...
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| Veröffentlicht in: | Journal of pediatric urology 2013-12, Vol.9 (6), p.820-824 |
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| creator | Yankovic, Francisca Swartz, Robert Cuckow, Peter Hiorns, Melanie Marks, Stephen D Cherian, Abraham Mushtaq, Imran Duffy, Patrick Smeulders, Naima |
| description | Abstract Objective Dextranomer-hyaluronic acid (Deflux® ), the most widely used compound in the endoscopic treatment of vesico-ureteric reflux (VUR) today, is believed to provoke only minimal inflammation. Reports of calcification of Deflux® are increasing. We ascertain the incidence of Deflux® calcification appearing as distal ureteric calculi on ultrasound. Methods Three cases (2 external patients) of ureteroscopy for calcified submucosal Deflux® prompted a retrospective review of the notes and imaging of all children treated with Deflux® for VUR between December 2000 and January 2011 at Great Ormond Street Hospital. Results 232 children ( M : F = 5:3) received Deflux® for VUR at median age 2 years (range 2 months–12 years). Follow-up annual ultrasound, performed in all, identified calcification in 2. The interval between Deflux® injection and presentation of its calcification was 4 years. 104 of the 232 children had been followed up for 4–10 years. Considering the observed lag-period, after 4 years the incidence of calcification of Deflux® on ultrasound was 2% (2/104). Conclusions Patients should be warned that calcification of Deflux® can occur. Misinterpretation as ureteric stones is common and may lead to unnecessary ureteroscopy. In this series, the incidence of calcification of Deflux® on ultrasound after 4 years was 2%. |
| doi_str_mv | 10.1016/j.jpurol.2012.10.025 |
| format | Article |
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Reports of calcification of Deflux® are increasing. We ascertain the incidence of Deflux® calcification appearing as distal ureteric calculi on ultrasound. Methods Three cases (2 external patients) of ureteroscopy for calcified submucosal Deflux® prompted a retrospective review of the notes and imaging of all children treated with Deflux® for VUR between December 2000 and January 2011 at Great Ormond Street Hospital. Results 232 children ( M : F = 5:3) received Deflux® for VUR at median age 2 years (range 2 months–12 years). Follow-up annual ultrasound, performed in all, identified calcification in 2. The interval between Deflux® injection and presentation of its calcification was 4 years. 104 of the 232 children had been followed up for 4–10 years. Considering the observed lag-period, after 4 years the incidence of calcification of Deflux® on ultrasound was 2% (2/104). Conclusions Patients should be warned that calcification of Deflux® can occur. Misinterpretation as ureteric stones is common and may lead to unnecessary ureteroscopy. In this series, the incidence of calcification of Deflux® on ultrasound after 4 years was 2%.</description><identifier>ISSN: 1477-5131</identifier><identifier>EISSN: 1873-4898</identifier><identifier>DOI: 10.1016/j.jpurol.2012.10.025</identifier><identifier>PMID: 23186595</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adolescent ; Calcification ; Calcinosis - diagnostic imaging ; Calcinosis - epidemiology ; Child ; Child, Preschool ; Deflux ; Dextranomer-hyaluronic acid ; Dextrans - adverse effects ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Hyaluronic Acid - adverse effects ; Hydronephrosis - diagnostic imaging ; Hydronephrosis - epidemiology ; Incidence ; Infant ; Male ; Pediatrics ; Retrospective Studies ; Risk Factors ; Tomography, X-Ray Computed ; Ultrasonography ; Ultrasound ; Ureteral Diseases - diagnostic imaging ; Ureteral Diseases - epidemiology ; Ureteric calculus ; Ureteroscopy ; Urinary Calculi - diagnostic imaging ; Urinary Calculi - epidemiology ; Urology ; Vesico-Ureteral Reflux - surgery</subject><ispartof>Journal of pediatric urology, 2013-12, Vol.9 (6), p.820-824</ispartof><rights>Journal of Pediatric Urology Company</rights><rights>2012 Journal of Pediatric Urology Company</rights><rights>Copyright © 2012 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c483t-4dc6e3d1f90e56be80f2462da8c8d78f2dba3774fb6d25f9fd70758c6ade43fc3</citedby><cites>FETCH-LOGICAL-c483t-4dc6e3d1f90e56be80f2462da8c8d78f2dba3774fb6d25f9fd70758c6ade43fc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jpurol.2012.10.025$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27928,27929,45999</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23186595$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yankovic, Francisca</creatorcontrib><creatorcontrib>Swartz, Robert</creatorcontrib><creatorcontrib>Cuckow, Peter</creatorcontrib><creatorcontrib>Hiorns, Melanie</creatorcontrib><creatorcontrib>Marks, Stephen D</creatorcontrib><creatorcontrib>Cherian, Abraham</creatorcontrib><creatorcontrib>Mushtaq, Imran</creatorcontrib><creatorcontrib>Duffy, Patrick</creatorcontrib><creatorcontrib>Smeulders, Naima</creatorcontrib><title>Incidence of Deflux® calcification masquerading as distal ureteric calculi on ultrasound</title><title>Journal of pediatric urology</title><addtitle>J Pediatr Urol</addtitle><description>Abstract Objective Dextranomer-hyaluronic acid (Deflux® ), the most widely used compound in the endoscopic treatment of vesico-ureteric reflux (VUR) today, is believed to provoke only minimal inflammation. Reports of calcification of Deflux® are increasing. We ascertain the incidence of Deflux® calcification appearing as distal ureteric calculi on ultrasound. Methods Three cases (2 external patients) of ureteroscopy for calcified submucosal Deflux® prompted a retrospective review of the notes and imaging of all children treated with Deflux® for VUR between December 2000 and January 2011 at Great Ormond Street Hospital. Results 232 children ( M : F = 5:3) received Deflux® for VUR at median age 2 years (range 2 months–12 years). Follow-up annual ultrasound, performed in all, identified calcification in 2. The interval between Deflux® injection and presentation of its calcification was 4 years. 104 of the 232 children had been followed up for 4–10 years. Considering the observed lag-period, after 4 years the incidence of calcification of Deflux® on ultrasound was 2% (2/104). Conclusions Patients should be warned that calcification of Deflux® can occur. Misinterpretation as ureteric stones is common and may lead to unnecessary ureteroscopy. In this series, the incidence of calcification of Deflux® on ultrasound after 4 years was 2%.</description><subject>Adolescent</subject><subject>Calcification</subject><subject>Calcinosis - diagnostic imaging</subject><subject>Calcinosis - epidemiology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Deflux</subject><subject>Dextranomer-hyaluronic acid</subject><subject>Dextrans - adverse effects</subject><subject>Diagnosis, Differential</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Hyaluronic Acid - adverse effects</subject><subject>Hydronephrosis - diagnostic imaging</subject><subject>Hydronephrosis - epidemiology</subject><subject>Incidence</subject><subject>Infant</subject><subject>Male</subject><subject>Pediatrics</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Tomography, X-Ray Computed</subject><subject>Ultrasonography</subject><subject>Ultrasound</subject><subject>Ureteral Diseases - diagnostic imaging</subject><subject>Ureteral Diseases - epidemiology</subject><subject>Ureteric calculus</subject><subject>Ureteroscopy</subject><subject>Urinary Calculi - diagnostic imaging</subject><subject>Urinary Calculi - epidemiology</subject><subject>Urology</subject><subject>Vesico-Ureteral Reflux - surgery</subject><issn>1477-5131</issn><issn>1873-4898</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkbtuFDEUQC0EIiHwB1E0Jc1s_Brb00RC4ZFIkSiAgsry2teRB-94sceI_BQfwZfhYUOKNFS2rs59nYvQKcEbgok4nzbTvuYUNxQT2kIbTIcn6JgoyXquRvW0_bmU_UAYOUIvSpkwZhLT8Tk6oowoMYzDMfp6PdvgYLbQJd-9BR_rz9-_OmuiDT5Ys4Q0dztTvlfIxoX5tjOlc6EsJnY1wwI52L90jaFraI1LNiXV2b1Ez7yJBV7dvyfoy_t3ny-v-puPH64v39z0liu29NxZAcwRP2IYxBYU9pQL6oyyyknlqdsaJiX3W-Ho4EfvJJaDssI44MxbdoJeH-ruc2pTlkXvQrEQo5kh1aIJb4sOIxW4ofyA2pxKyeD1PoedyXeaYL1K1ZM-SNWr1DXapLa0s_sOdbsD95D0z2IDLg4AtD1_BMi62LA6dSGDXbRL4X8dHhewMcxNf_wGd1CmVPPcHGqiC9VYf1oPu96VUIyp4IT9AWN8oc0</recordid><startdate>20131201</startdate><enddate>20131201</enddate><creator>Yankovic, Francisca</creator><creator>Swartz, Robert</creator><creator>Cuckow, Peter</creator><creator>Hiorns, Melanie</creator><creator>Marks, Stephen D</creator><creator>Cherian, Abraham</creator><creator>Mushtaq, Imran</creator><creator>Duffy, Patrick</creator><creator>Smeulders, Naima</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20131201</creationdate><title>Incidence of Deflux® calcification masquerading as distal ureteric calculi on ultrasound</title><author>Yankovic, Francisca ; Swartz, Robert ; Cuckow, Peter ; Hiorns, Melanie ; Marks, Stephen D ; Cherian, Abraham ; Mushtaq, Imran ; Duffy, Patrick ; Smeulders, Naima</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c483t-4dc6e3d1f90e56be80f2462da8c8d78f2dba3774fb6d25f9fd70758c6ade43fc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Calcification</topic><topic>Calcinosis - diagnostic imaging</topic><topic>Calcinosis - epidemiology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Deflux</topic><topic>Dextranomer-hyaluronic acid</topic><topic>Dextrans - adverse effects</topic><topic>Diagnosis, Differential</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Hyaluronic Acid - adverse effects</topic><topic>Hydronephrosis - diagnostic imaging</topic><topic>Hydronephrosis - epidemiology</topic><topic>Incidence</topic><topic>Infant</topic><topic>Male</topic><topic>Pediatrics</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Tomography, X-Ray Computed</topic><topic>Ultrasonography</topic><topic>Ultrasound</topic><topic>Ureteral Diseases - diagnostic imaging</topic><topic>Ureteral Diseases - epidemiology</topic><topic>Ureteric calculus</topic><topic>Ureteroscopy</topic><topic>Urinary Calculi - diagnostic imaging</topic><topic>Urinary Calculi - epidemiology</topic><topic>Urology</topic><topic>Vesico-Ureteral Reflux - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yankovic, Francisca</creatorcontrib><creatorcontrib>Swartz, Robert</creatorcontrib><creatorcontrib>Cuckow, Peter</creatorcontrib><creatorcontrib>Hiorns, Melanie</creatorcontrib><creatorcontrib>Marks, Stephen D</creatorcontrib><creatorcontrib>Cherian, Abraham</creatorcontrib><creatorcontrib>Mushtaq, Imran</creatorcontrib><creatorcontrib>Duffy, Patrick</creatorcontrib><creatorcontrib>Smeulders, Naima</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of pediatric urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yankovic, Francisca</au><au>Swartz, Robert</au><au>Cuckow, Peter</au><au>Hiorns, Melanie</au><au>Marks, Stephen D</au><au>Cherian, Abraham</au><au>Mushtaq, Imran</au><au>Duffy, Patrick</au><au>Smeulders, Naima</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence of Deflux® calcification masquerading as distal ureteric calculi on ultrasound</atitle><jtitle>Journal of pediatric urology</jtitle><addtitle>J Pediatr Urol</addtitle><date>2013-12-01</date><risdate>2013</risdate><volume>9</volume><issue>6</issue><spage>820</spage><epage>824</epage><pages>820-824</pages><issn>1477-5131</issn><eissn>1873-4898</eissn><abstract>Abstract Objective Dextranomer-hyaluronic acid (Deflux® ), the most widely used compound in the endoscopic treatment of vesico-ureteric reflux (VUR) today, is believed to provoke only minimal inflammation. Reports of calcification of Deflux® are increasing. We ascertain the incidence of Deflux® calcification appearing as distal ureteric calculi on ultrasound. Methods Three cases (2 external patients) of ureteroscopy for calcified submucosal Deflux® prompted a retrospective review of the notes and imaging of all children treated with Deflux® for VUR between December 2000 and January 2011 at Great Ormond Street Hospital. Results 232 children ( M : F = 5:3) received Deflux® for VUR at median age 2 years (range 2 months–12 years). Follow-up annual ultrasound, performed in all, identified calcification in 2. The interval between Deflux® injection and presentation of its calcification was 4 years. 104 of the 232 children had been followed up for 4–10 years. Considering the observed lag-period, after 4 years the incidence of calcification of Deflux® on ultrasound was 2% (2/104). Conclusions Patients should be warned that calcification of Deflux® can occur. Misinterpretation as ureteric stones is common and may lead to unnecessary ureteroscopy. In this series, the incidence of calcification of Deflux® on ultrasound after 4 years was 2%.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>23186595</pmid><doi>10.1016/j.jpurol.2012.10.025</doi><tpages>5</tpages></addata></record> |
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| subjects | Adolescent Calcification Calcinosis - diagnostic imaging Calcinosis - epidemiology Child Child, Preschool Deflux Dextranomer-hyaluronic acid Dextrans - adverse effects Diagnosis, Differential Female Follow-Up Studies Humans Hyaluronic Acid - adverse effects Hydronephrosis - diagnostic imaging Hydronephrosis - epidemiology Incidence Infant Male Pediatrics Retrospective Studies Risk Factors Tomography, X-Ray Computed Ultrasonography Ultrasound Ureteral Diseases - diagnostic imaging Ureteral Diseases - epidemiology Ureteric calculus Ureteroscopy Urinary Calculi - diagnostic imaging Urinary Calculi - epidemiology Urology Vesico-Ureteral Reflux - surgery |
| title | Incidence of Deflux® calcification masquerading as distal ureteric calculi on ultrasound |
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