Incidentally detected ureteral fibroepithelial polyps in children: is endoscopic treatment of them really necessary?

Int Urol Nephrol. 2010 Mar;42(1):1-5. doi: 10.1007/s11255-009-9567-4. Epub 2009 Apr 21.

Abstract

Objective: Fibroepithelial polyps (FEPs) are the most common benign lesions of the ureter. However, FEPs of the ureter accompanied by calculi are rare. In this study, we reviewed our experiences with five children having FEP associated with ureteral calculi to define more clearly this entity and its outcome following observation.

Materials and methods: We identified five children who were intraoperatively found to have FEP associated with ureteral calculi during the period 2000-2008.

Results: The patients included four males and one female, and the average age of these patients was 6.4 years (range 4-9). The main symptoms were flank pain (five patients), hematuria (four patients), and dysuria (two patients). Radiographically, all patients showed complete ureteral obstruction due to distal ureter stone and hydronephrosis. Fibroepithelial polyps and stones were located left distal ureter in all children. These polyps were 1-2 cm, with a mean size of 1.5 cm. Stone sizes ranged from 5 to 13 mm (mean 8.8 mm). The stones were smashed into smaller fragments using a pneumatic lithotriptor, and the pieces were removed with forceps. After the lithotripsy, the polyps were grasped with biopsy forceps and punch biopsies were done. FEPs were diagnosed in all cases by postoperative histological examination. During the follow-up period of these patients, none of the FEPs displayed any growth or symptom.

Conclusions: Due to the potential complications during the ureteroscopic resection, our opinion is to observe the small FEPs without joint symptoms and hydronephrosis.

MeSH terms

  • Child
  • Child, Preschool
  • Female
  • Humans
  • Incidental Findings
  • Male
  • Polyps / surgery*
  • Ureteral Calculi / complications
  • Ureteral Diseases / complications
  • Ureteral Diseases / surgery*
  • Ureteroscopy*