Urogenit Tract Infect.  2016 Aug;11(2):62-65. 10.14777/uti.2016.11.2.62.

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

• Choi JY
• Kim HT
• Ko YH
• Lee YH
• Song PH

• KMID: 2350758
• DOI: http://doi.org/10.14777/uti.2016.11.2.62

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.

Keyword

Vesico-ureteral reflux; Subureteral injection; Urinary bladder calculi

MeSH Terms

Child
Dysuria
Female
Humans
Hydronephrosis
Lower Urinary Tract Symptoms
Pyelonephritis
Recurrence
Urinary Bladder Calculi*
Urinary Bladder*
Urinary Tract Infections*
Urinary Tract*
Vesico-Ureteral Reflux*

Figure

• 

  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.

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

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  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.

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  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.

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