No abstract

Primary non-syndromic vesicoureteral reflux (VUR) is the commonest paediatric anomaly of the urinary tract. Complications of high-grade VUR include recurrent urinary tract infections, pyelonephritis, reflux nephropathy, and irreversible renal failure. The primary aim of its management centres on minimizing the number of urinary tract infections and renal scarring via surgical correction or continuous antibiotic prophylaxis. A rare complication of surgical treatment by subureteric Teflon injection with non-animal stabilized hyaluronic acid/dextranomer gel (NASHA/Dx) is ureteric obstruction. We report the case of a 38-year-old female who was diagnosed with ureteric obstruction secondary to subureteric injection with Deflux injection 30 years after endoscopic correction of VUR. She was successfully treated with ureteric reimplantation. Although considered efficient and safe, subureteric injection of bulking agent Deflux can be associated with delayed ureteric obstruction. This case highlights the need for long-term follow-up to allow timely detection and management of delayed ureteric obstruction. The possibility of late complication must also be addressed when obtaining pre-operative informed consent

We present an unusual case of a retained resectoscope beak detected 10 months following transurethral resection of a bladder tumour. We describe this rare complication after transurethral surgery and present a safe method for removing a resectoscope beak from the urethra. This case prompted several improvements in our local surgical checklists to prevent such an event from recurring. It is important to check the integrity of surgical equipment in addition to counting equipment in and out during theatre; without checking, as exemplified by the resectoscope in this case, we risk missing the point.