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Published on: July 28, 2012
Dextranomer-hyaluronic acid implants misdiagnosed as bladder tumor on transvaginal ultrasonography
John J DeCaro1, Andrew J Kirsch
1From the Division of Pediatric Urology, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia.
Insights
Adult women treated for childhood vesicoureteral reflux with dextranomer-hyaluronic acid implants may be misdiagnosed. Awareness of implant appearance prevents unnecessary invasive procedures.
Area of Science:
- Urology
- Pediatric Urology
- Diagnostic Imaging
Background:
- Dextranomer-hyaluronic acid (DX-HA) injections are a common treatment for pediatric vesicoureteral reflux (VUR).
- A significant number of treated girls are now reaching adulthood.
- Radiographic findings of DX-HA implants can mimic other conditions in children.
Background:
The endoscopic injection of dextranomer-hyaluronic acid has become a popular treatment for childhood vesicoureteral reflux. Treated children are predominantly girls, and many are now entering adulthood. It has been reported in children that the radiographic appearance of implants may lead to misdiagnoses and unnecessary, invasive diagnostic procedures.
Case:
We report the case of a woman treated with dextranomer-hyaluronic acid for childhood vesicoureteral reflux misdiagnosed with a bladder tumor on transvaginal ultrasonography. Renal ultrasound examination and urinalysis results were normal. Invasive testing was avoided given the history and characteristic ultrasonographic appearance of retained implants.
Conclusion:
It is important for health care providers to be aware of the radiographic appearance of dextranomer-hyaluronic acid implants in adults and to elicit an appropriate past medical history to avoid misdiagnosis and invasive diagnostic procedures.
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