Inflammatory Changes Induced by Dextranomer/ Hyaluronic Acid Injection into the Several Different Wall Layers of Ureterovesical Junction

Objective: Endoscopic subureteric injection (ESI) is a minimally invasive and effective method for the treatment of vesicoureteral reflux. Ureterovesical junction (UVJ) obstruction after subureteric dextranomer/hyaluronic acid (Dx/HA) injection
has been reported in the literature. Inflammatory changes in the several different wall layers of the UVJ after injection of Dx/
HA have not been investigated before. The aim of this study is to evaluate the inflammatory response induced by Dx/HA in the several different wall layers of UVJ in an experimental rat model.

Methods: Dx/HA was injected into the UVJ submucosally, intramuscularly, and adventitially to the consecutive group of rats. Inflammatory cell densities were determined and granuloma thickness was measured under the light microscope.

Results: Density of mononuclear cells, macrophages, giant cells, and thickness of granuloma formation have been found to be increased in the muscular layer and adventitial layer injection groups compared to the submucosal layer injection group (P < .01). However, the highest chronic inflammatory response has been found in the adventitial layer injection group whereas the lowest chronic inflammatory response has been found in the submucosal layer injection group (P < .01).

Conclusion: We conclude that injection of the Dx/HA into the correct ureteral wall layer is important to minimize the risk of severe inflammatory response resulting in UVJ obstruction.

Cite this article as: Mubaris Abdullahoğlu D, Ulusoy O, Zeki Karakuş O, et al. Inflammatory changes induced by dextranomer/hyaluronic acid injection into the several different wall layers of ureterovesical junction. Turk J Nephrol. 2021; 30(2): 153-157.