Dextranomer/Hyaluronic Acid Copolymer Implant Calcification Mimicking Distal Ureteral Calculi on Ultrasound

Clark, Aaron T.D.; Guerra, Luis; Leonard, Michael P.

doi:10.1016/j.urology.2009.06.007

Cited by 16 publications

(4 citation statements)

References 8 publications

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“…One interesting complication following dextranomer and hyaluronic acid injections has been clinical confusion. For instance, there have been several cases of the dextranomer/ hyaluronic acid injection calcifying after treatment of vesicoureteral reflux and mimicking nephrolithiasis or even a bladder tumor, resulting in unnecessary work-up and interventions (4,(7)(8)(9)(10)(11). In a case report of a patient treated for fecal incontinence, a subepithelial lesion was incidentally found on routine screening colonoscopy, and the patient subsequently underwent multiple procedures including flexible sigmoidoscopy, endoscopic ultrasonography, and fine-needle aspiration, only to discover that the lesion was simply a remainder of the dextranomer/ hyaluronic injection (4).…”

Section: Discussionmentioning

confidence: 99%

Migrated Bulking Material (Solesta) Presenting as a Vaginal “Cyst”: Histopathologic and Chemical Analytical Features

Zhu

Matz

Lewin-Smith

et al. 2021

International Journal of Gynecological Pathology

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Performing injections with a bulking agent consisting of nonanimal stabilized hyaluronic acid and dextranomer is a well-tolerated and efficacious treatment for mild to moderate fecal incontinence. Here, we discuss a case of a patient with a history of a bulking procedure for fecal incontinence who presented to the obstetrics/gynecology clinic for evaluation of a new vaginal "cyst," which was excised. Histopathologic examination revealed migrated bulking agent within the excised specimen.

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Section: Discussionmentioning

confidence: 99%

Migrated Bulking Material (Solesta) Presenting as a Vaginal “Cyst”: Histopathologic and Chemical Analytical Features

Zhu

Matz

Lewin-Smith

et al. 2021

International Journal of Gynecological Pathology

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“…There have been many vesicoureteral reflux (VUR) cases in the literature which created clinical confusion, unnecessary interventions, and even misdiagnoses in patients with previous histories of DxHA injections. Multiple reports have described calcified DxHA mimicking distal ureteral calculi, sometimes leading to cystoscopy or ureteroscopy [ 12 – 15 ]. In one case, a patient with a past history of VUR was referred by her gynecologist to the pediatric urologist after misdiagnosing DxHA implants on transvaginal ultrasonography as a bladder tumor [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic, Ultrasonographic, and Histologic Descriptions of Dextranomer/Hyaluronic Acid in a Case of Fecal Incontinence

Irwin

Snow

Orton

et al. 2018

Case Reports in Pathology

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Objective To present a case of fecal incontinence treated with dextranomer/hyaluronic acid (Solesta®) injections, which later caused clinical confusion and avoidable interventions. The endoscopic, ultrasonographic, and histologic appearances of dextranomer/hyaluronic acid will also be reported. Case Presentation A middle-aged Hispanic male who failed conservative management of his fecal incontinence was injected with dextranomer/hyaluronic acid in an attempt to alleviate symptoms. An unrelated screening colonoscopy was performed soon after, revealing a submucosal rectal lesion. Flexible sigmoidoscopy and endoscopic rectal ultrasound with FNA were scheduled for patient for further evaluation. An unknown foreign material was noted under microscopy and, upon attaining additional history, the gastroenterologist uncovered the patient's recent injections of dextranomer/hyaluronic acid. Conclusion Dextranomer/hyaluronic acid for the treatment of fecal incontinence has become more common in recent years. Though the imaging and histologic appearance of this gel-like material is seen in other areas of medicine, equivalent descriptions are limited in the anorectal region. To curb misdiagnoses and prevent unnecessary interventions, it is important to expound on the endoscopic, imaging, and histopathologic features of this tissue-bulking agent in the setting of fecal incontinence and to encourage communication, proper documentation, and easy accessibility to patient health information by all medical staff.

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“…[3738] These high-density lesions on CT and US examinations have the potential to be misdiagnosed as urolithiasis. [3839] A history of surgical treatment for VUR should alert the practitioner to the possibility of this finding. If a high-density focus is found, concomitant hydroureteronephrosis may help distinguish true urolithiasis from calcified implants.…”

Section: Acute Evaluationmentioning

confidence: 99%

Evaluation of pediatric nephrolithiasis

2010

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Nephrolithiasis in the pediatric population is an important cause of morbidity worldwide. Presenting signs and symptoms are often considerably different from those in adults. Vague abdominal pain, hematuria, and urinary tract infection are more common in children than the classic colicky flank pain. Imaging of suspected cases should be undertaken with careful consideration of diagnostic accuracy and the potentially harmful effects of ionizing radiation. Because children with nephrolithiasis have a high chance of recurrent stone formation, a thorough risk assessment and metabolic evaluation should be performed. This review discusses the presentation, acute evaluation and risk assessment of nephrolithiasis in the pediatric population.

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Dextranomer/Hyaluronic Acid Copolymer Implant Calcification Mimicking Distal Ureteral Calculi on Ultrasound

Cited by 16 publications

References 8 publications

Migrated Bulking Material (Solesta) Presenting as a Vaginal “Cyst”: Histopathologic and Chemical Analytical Features

Migrated Bulking Material (Solesta) Presenting as a Vaginal “Cyst”: Histopathologic and Chemical Analytical Features

Endoscopic, Ultrasonographic, and Histologic Descriptions of Dextranomer/Hyaluronic Acid in a Case of Fecal Incontinence

Evaluation of pediatric nephrolithiasis

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