Distal ureteral calcification secondary to deflux injection: a reality or myth?

Dextranomer/hyaluronic acid (Dx/HA) copolymer (Deflux) subureteral injection has become a widely accepted form of treatment for vesicoureteral reflux. Long-term histologic studies, both experimental and clinical, have supported and proven the occurrence of calcification at the site of previous injection. These calcifications in clinical settings may be perceived as ureteral stones. We report a case of an adolescent female with unresolved right-sided abdominal pain with a past surgical history of Deflux injection, who presented with a distal ureteral calcification. Upon further investigation the calcification was found to be confined to the submural portion rather than the intraluminal ureter.