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Wang X, Zhang Y, Zhang J, Li Z, Han G, Zhang L, Li X, Yang K, Wang B, Zhang P, Huang C, Liu J, Zhu H, Zhou L, Zhang K, Li X. Minimal-invasive ileal ureter replacement for the management of multiple ureteral polyps: the initial experience. Int Urol Nephrol 2024; 56:1919-1926. [PMID: 38200364 DOI: 10.1007/s11255-023-03850-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 10/09/2023] [Indexed: 01/12/2024]
Abstract
PURPOSE To present our initial experience in the management of multiple ureteral polyps with robotic or laparoscopic ileal ureter replacement (IUR). METHODS Eight consecutive patients diagnosed with multiple ureteral polyps underwent robotic or laparoscopic IUR between July 2019 and November 2022. Unilateral IUR was performed in 5 patients with polyps in the left (n = 3) or right (n = 2) side, and 3 patients with bilateral multiple polyps underwent bilateral IUR. Demographic characteristics, perioperative data and follow-up outcomes were prospectively collected. RESULTS A cohort of 5 male and 3 female patients (11 ureters) with a mean age of 32.8 ± 11.3 years were included. Among these patients, 5 presented with recurrent flank pain, 1 had hematuria, and 2 were asymptomatic. Four patients experienced prior failed surgical interventions. The mean length of diseased ureter was 11.9 ± 4.7 cm, with more than 10 cm in eight sides. All procedures were performed successfully. The mean operation time was 319 ± 87.6 min with 3 patients who simultaneously underwent intraoperative ureteroscopy. The mean length of ileal graft was 23.8 ± 5.8 cm. During the mean follow-up of 20.4 ± 12.8 months, one major complication, specifically incision infection, and four minor complications, including urinary infection (n = 3) and metabolic acidosis (n = 1), were observed. All patients presented symptom-free, with improved/stabilized hydronephrosis and no signs of restenosis. CONCLUSION Robotic or laparoscopic IUR is a feasible, safe, and effective surgical option for patients with long ureteral defects caused by multiple polyps.
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Affiliation(s)
- Xiang Wang
- Department of Urology, Peking University First Hospital, Institute of Urology, National Urological Cancer Centre, Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China
| | - Yiming Zhang
- Department of Urology, Peking University First Hospital, Institute of Urology, National Urological Cancer Centre, Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China
| | - Jilong Zhang
- Department of Urology, Peking University First Hospital, Institute of Urology, National Urological Cancer Centre, Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China
| | - Zhihua Li
- Department of Urology, Peking University First Hospital, Institute of Urology, National Urological Cancer Centre, Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China
- Department of Nursing, Peking University First Hospital, Peking University, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China
| | - Guanpeng Han
- Department of Urology, Peking University First Hospital, Institute of Urology, National Urological Cancer Centre, Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China
| | - Lianghao Zhang
- Department of Urology, Peking University First Hospital, Institute of Urology, National Urological Cancer Centre, Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China
| | - Xinfei Li
- Department of Urology, Peking University First Hospital, Institute of Urology, National Urological Cancer Centre, Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China
| | - Kunlin Yang
- Department of Urology, Peking University First Hospital, Institute of Urology, National Urological Cancer Centre, Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China
| | - Bing Wang
- Department of Urology, Peking University First Hospital, Institute of Urology, National Urological Cancer Centre, Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China
| | - Peng Zhang
- Department of Urology, Emergency General Hospital, No. 29 Xibahenanli St, Chaoyang District, Beijing, 100020, China
| | - Chen Huang
- Department of Urology, Beijing Jiangong Hospital, No. 6 Rufuli St, Xicheng District, Beijing, 100034, China
| | - Jing Liu
- Department of Urology, Beijing Jiangong Hospital, No. 6 Rufuli St, Xicheng District, Beijing, 100034, China
| | - Hongjian Zhu
- Department of Urology, Beijing Jiangong Hospital, No. 6 Rufuli St, Xicheng District, Beijing, 100034, China
| | - Liqun Zhou
- Department of Urology, Peking University First Hospital, Institute of Urology, National Urological Cancer Centre, Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China
| | - Kai Zhang
- Department of Urology, Peking University First Hospital, Institute of Urology, National Urological Cancer Centre, Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China.
| | - Xuesong Li
- Department of Urology, Peking University First Hospital, Institute of Urology, National Urological Cancer Centre, Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China.
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Chen B, Xu L, Fan Y, Zhao L, Sun J, Huang J. Minimally Invasive Surgical Therapies for Ureteral Polyps: A Systematic Review. J Laparoendosc Adv Surg Tech A 2024; 34:313-317. [PMID: 38294894 DOI: 10.1089/lap.2023.0477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Abstract
Background: Ureteral polyps are rare benign ureteral tumor. No guideline recommends that open or minimally invasive surgery is best for treating ureteral polyps. This article aims to provide a comprehensive review of the minimally invasive techniques currently available for treating ureteral polyps. Materials and Methods: We performed a comprehensive search of articles published in PubMed, using the keywords "ureteral" and "polyp," or "polyps." Results: A total of 275 studies were obtained from the literature search but 96 articles were excluded. Conclusions: Several minimally invasive approaches were developed with the advancement of medical technology, including endoscopic, laparoscopic, and robotic approaches; however, the best surgical technique was yet to be decided. Due to the advantages and disadvantages of these approaches, the best surgical approach should be tailored to each patient's needs and the surgeon's preferences and experience.
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Affiliation(s)
- Bohong Chen
- Department of Urology, Hangzhou Ninth People's Hospital, Hangzhou, China
| | - Li Xu
- School of Medicine, Hangzhou Normal University, Hangzhou, China
| | - Yi Fan
- Department of Urology, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
| | - Liwei Zhao
- Department of Urology, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
| | - Ji Sun
- Department of Urology, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
| | - Jiaguo Huang
- Department of Urology, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
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Zhanghuang C, Hang Y, Ji F, Long N, Yao Z, Li L, Yang Z, Tang H, Zhang K, Wu C, Xie Y, Yan B. Congenital giant fibroepithelial polyp of the scrotum in an infant: the first case report from China. Front Pediatr 2023; 11:1191983. [PMID: 37492601 PMCID: PMC10364443 DOI: 10.3389/fped.2023.1191983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 06/26/2023] [Indexed: 07/27/2023] Open
Abstract
Giant fibroepithelial polyp (FP) of the scrotum in infants is a rare disease. We reported the first case of FP in China. The child was only 9 months and 12 days old and was admitted to the hospital due to rapid growth and rupture of the scrotal mass. The patient underwent scrotal exploration under general anesthesia, and the mass was cystic-solid with clear boundaries. The tumor did not invade the sarcolemma of the scrotum and testicular tissue. The intraoperative pathological frozen section tended to be benign, and the scrotum's tumor and subcutaneous pedicle tissue were removed entirely after 0.5 cm from the boundary of the mass. The operation was successful. The mass was confirmed as FP by postoperative pathology. 6 months after the operation, the incision healed well without recurrence. This case report has a detailed diagnosis and treatment process and adequate examination results. It can provide a reference for diagnosing and treating FP in infants and reduce the risk of misdiagnosis and mistreatment.
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Affiliation(s)
- Chenghao Zhanghuang
- Department of Urology, Kunming Children’s Hospital (Children’s Hospital Affiliated to Kunming Medical University), Kunming, China
- Yunnan Key Laboratory of Children’s Major Disease Research, Yunnan Province Clinical Research Center for Children’s Health and Disease, Kunming, China
| | - Yu Hang
- Department of Urology, Kunming Children’s Hospital (Children’s Hospital Affiliated to Kunming Medical University), Kunming, China
| | - Fengming Ji
- Department of Urology, Kunming Children’s Hospital (Children’s Hospital Affiliated to Kunming Medical University), Kunming, China
| | - Na Long
- Department of Special Needs Ward, Kunming Children’s Hospital (Children’s Hospital Affiliated to Kunming Medical University), Kunming, China
| | - Zhigang Yao
- Department of Urology, Kunming Children’s Hospital (Children’s Hospital Affiliated to Kunming Medical University), Kunming, China
| | - Li Li
- Yunnan Key Laboratory of Children’s Major Disease Research, Yunnan Province Clinical Research Center for Children’s Health and Disease, Kunming, China
| | - Zhen Yang
- Department of Oncology, Yunnan Children Solid Tumor Treatment Center, Kunming Children’s Hospital (Children’s Hospital Affiliated to Kunming Medical University), Kunming, China
| | - Haoyu Tang
- Department of Urology, Kunming Children’s Hospital (Children’s Hospital Affiliated to Kunming Medical University), Kunming, China
| | - Kun Zhang
- Department of Urology, Kunming Children’s Hospital (Children’s Hospital Affiliated to Kunming Medical University), Kunming, China
| | - Chengchuang Wu
- Department of Urology, Kunming Children’s Hospital (Children’s Hospital Affiliated to Kunming Medical University), Kunming, China
| | - Yucheng Xie
- Department of Pathology, Kunming Children’s Hospital (Children’s Hospital Affiliated to Kunming Medical University), Kunming, China
| | - Bing Yan
- Department of Urology, Kunming Children’s Hospital (Children’s Hospital Affiliated to Kunming Medical University), Kunming, China
- Department of Special Needs Ward, Kunming Children’s Hospital (Children’s Hospital Affiliated to Kunming Medical University), Kunming, China
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Cho SY, Oh KJ, Jung W, Kim HJ, Lee SH, Lee JY, Lee DS. The natural course of incidental ureteral polyp during ureteroscopic surgery: KSER research. BMC Urol 2023; 23:101. [PMID: 37316777 DOI: 10.1186/s12894-023-01249-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 04/14/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND The natural course of polypoid lesions in the ureter during ureteroscopic stone surgery was not yet clarified. METHODS Patient data were collected prospectively from six teaching hospitals between 2019 and 2021. Patients with polypoid lesions in the ureter distal to ureteral stones were included during ureteroscopy. Computed tomography was performed on all enrolled patients three months after the procedure. Follow-up ureteroscopy was performed only if the patient consented, due to the need for general anesthesia and ethical considerations. RESULTS Among the 35 patients who were followed up, 14 had fibroepithelial polyps and 21 had inflammatory polyps. Twenty of the followed-up patients underwent ureteroscopy, and nine of them had fibroepithelial polyps. Although fibroepithelial polyps did not disappear in the follow-up ureteroscopy (p = 0.002), the rate of postoperative hydronephrosis was not higher in the fibroepithelial group than in the inflammatory group. Postoperative ureteral stricture and moderate-to-severe hydronephrosis were found to be closely related to the number of resected polyps, regardless of the type of polyp (p = 0.014 and 0.006, respectively). CONCLUSION Fibroepithelial polyps in the ureter may persist after treatment of adjacent ureter stones. However, conservative management may be preferable to active removal of ureteral polyps because fibroepithelial polyps may not contribute to clinically significant hydronephrosis after surgery, and inflammatory polyps disappear spontaneously. Hasty resections of polyps may increase the risk of ureteral stricture.
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Affiliation(s)
- Sung Yong Cho
- Department of Urology, Seoul National University Hospital, Seoul National University, College of Medicine, Seoul, South Korea
| | - Kyung-Jin Oh
- Department of Urology, Chonnam National University Medical School, Gwangju, South Korea
| | - Wonho Jung
- Department of Urology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, South Korea
| | - Hyung Joon Kim
- Department of Urology, Konyang University Hospital, Daejeon, South Korea
| | - Sang Hyub Lee
- Department of Urology, School of Medicine, Kyung Hee University, Kyung Hee University Medical Center, Seoul, South Korea
| | - Joo Yong Lee
- Department of Urology, Urological Science Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Dong Sup Lee
- Department of Urology, St. Vincent's hospital, The Catholic University of Korea, Suwon, South Korea.
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Li J, Jiang C, Liao X, Yan S, Huang S, Liu S, Liu Q. Ureteral inflammatory edema grading clinical application. Front Surg 2023; 9:1038776. [PMID: 36684315 PMCID: PMC9852048 DOI: 10.3389/fsurg.2022.1038776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/11/2022] [Indexed: 01/07/2023] Open
Abstract
Purpose To evaluate the relationship between endoscopic ureteral inflammatory edema (UIE) and ureteral lumen, formulate a preliminary grading method for the severity of UIE, and analyze the impact of different grades of UIE on endoscopic ureteral calculi surgery and prognosis. Materials and methods We retrospectively analyzed 185 patients who underwent ureteroscopic lithotripsy (URSL) for upper urinary tract stones between January 2021 and November 2021. The UIE grade and lumen conditions were assessed by endoscopic observation. The effect of UIE grade on URSL and on patient prognosis were analyzed by multiple linear regression and binary logistic regression. Results A total of 185 patients were included in the study. UIE grade showed a significant correlation with age, hydronephrosis grading (HG), ureteroscope placement time (UPT), surgery time (ST), hemoglobin disparity value (HDV), and postoperative ureteral stenosis (PUS) (P < 0.05). Logistics regression analysis showed a gradual increase in intraoperative UPT and ST with increase in UIE grade. The severity of UIE showed a negative correlation with improvement of postoperative hydronephrosis (IPH) and the appearance of PUS. HDV was significantly increased in patients with UIE grade 3. Conclusions UIE grading can be used as an adjunctive clinical guide for endoscopic treatment of upper urinary tract stones. The postoperative management measures proposed in this study can help inform treatment strategy for ureteral stones.
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Affiliation(s)
- Jialin Li
- The First Clinical College, Gannan Medical University, Ganzhou, China,Department of Urology, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Chengming Jiang
- The First Clinical College, Gannan Medical University, Ganzhou, China,Department of Urology, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Xinzhi Liao
- The First Clinical College, Gannan Medical University, Ganzhou, China,Department of Urology, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Sheng Yan
- The First Clinical College, Gannan Medical University, Ganzhou, China,Department of Urology, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Sigen Huang
- The First Clinical College, Gannan Medical University, Ganzhou, China,Department of Urology, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Shengyin Liu
- The First Clinical College, Gannan Medical University, Ganzhou, China,Department of Urology, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Quanliang Liu
- Department of Urology, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China,Correspondence: Quanliang Liu
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Buckland BC, Blatt A. Fibroepithelial polyp of the ureter: a prolapsing ureteric mass. ANZ J Surg 2022; 93:1031-1032. [PMID: 36121107 DOI: 10.1111/ans.18057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 08/25/2022] [Accepted: 08/30/2022] [Indexed: 11/29/2022]
Affiliation(s)
| | - Alison Blatt
- Department of Urology, John Hunter Hospital, New Lambton Heights, New South Wales, Australia
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Law YXT, Hong SKF, Wong CF, Ogloblin I, Teo HYC, Lee YM. Ureteral fibroepithelial polyp mimicking urothelial carcinoma. JOURNAL OF CLINICAL UROLOGY 2022. [DOI: 10.1177/2051415819863965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | | | - Chin Fong Wong
- Department of Pathology, Tan Tock Seng Hospital, Singapore
| | - Ivan Ogloblin
- Department of Pathology, Tan Tock Seng Hospital, Singapore
| | | | - Yee Mun Lee
- Department of Urology, Tan Tock Seng Hospital, Singapore
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Numano Y, Nomura K, Watanabe M, Sugawara M, Hemmi T, Suzuki J, Katori Y. Fibroepithelial Polyps Originating from the Posterior Nasal Septum: A Case Report. TOHOKU J EXP MED 2022; 257:333-336. [PMID: 35691915 DOI: 10.1620/tjem.2022.j047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Fibroepithelial polyps are benign tumors of mesodermal origin. They rarely occur in the nasal cavity, with only four such cases reported in the relevant English literature. The location was the inferior turbinate in three cases and anterior nasal septum in one case. The etiology has been suggested in other organs; however, it is entirely unknown in the nasal cavity. Pathological findings play an essential role in the diagnosis of fibroepithelial polyps. We report the case of a 76-year-old woman with fibroepithelial polyps originating from the posterior part of the nasal septum. The fibroepithelial polyps were white-yellow lobular masses that differed from a common inflammatory polyp. We made the diagnosis by excluding the other possible tumors based on a pathological examination. This is the first report about fibroepithelial polyps arising from the posterior nasal septum. She had no potential risk factors that might trigger fibroepithelial polyps in the nasal cavity. This case is a valuable example when considering the potential causes (e.g., female hormones and mechanical pressure) of nasal fibroepithelial polyps.
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Affiliation(s)
- Yuki Numano
- Department of Otolaryngology, Tohoku Kosai Hospital
| | | | | | | | - Tomotaka Hemmi
- Department of Otolaryngology, Head and Neck Surgery, Tohoku University Hospital
| | - Jun Suzuki
- Department of Otolaryngology, Head and Neck Surgery, Tohoku University Hospital
| | - Yukio Katori
- Department of Otolaryngology, Head and Neck Surgery, Tohoku University Hospital
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Griggs-Demmin A, Mudalegundi S, Haney N, Cohen A. Robotic Excision of Large, Multi-Focal Ureteral Fibroepipthelial Polyps. Urology 2022; 167:e3. [PMID: 35728672 DOI: 10.1016/j.urology.2022.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 05/24/2022] [Accepted: 06/05/2022] [Indexed: 10/18/2022]
Abstract
Ureteral fibroepithelial polyps (UFP) are benign neoplasms of mesodermal origin. In this report, we describe the rare presentation and robotic surgical management of UFP in an adult female. A 25-year-old female with recurrent bilateral UFP s/p multiple ureteroscopic ablations and right partial ureterectomy with ureto-ureteral anastomosis presented with left flank pain. Four-phase CT with delayed images demonstrated a filling defect in the left ureter. Ureteroscopy confirmed left UFP. The number, size, and multifocality precluded endoscopic management. Creatinine was normal and split function 53%/47%. The patient was recommended for robotic repair. After mobilization of the colon, the ureter was identified and traced up to the hilum. There was an inflammatory rind surrounding the ureter through majority of its length. Care was taken to avoid circumferential dissection of the ureter. Upon longitudinal incision of the ureter, polyps erupted with a release of hydronephrotic urine, despite pre-stenting. Polyps were transected at their base, revealing abnormal underlying urothelium. A ureteroscope was advanced through a robotic port to examine the proximal ureter and renal pelvis. Remaining polyps were removed after which a wire and stent was placed antegrade into the open distal ureter and proximally into the renal pelvis. The anastomosis was performed with 5-0 PDS. ICG and firefly confirmed suitable blood flow to the ureter. Pathology revealed benign fibroepithelial polyps with reactive changes to the urothelium. Retrograde pyelogram two months later revealed a patent ureter. This video demonstrates successful robotic surgical management of large, multifocal UFPs.
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Affiliation(s)
| | - Shwetha Mudalegundi
- Johns Hopkins University School of Medicine, 733 N. Broadway, Baltimore, MD 21205 USA.
| | - Nora Haney
- Brady Urological Institute, Johns Hopkins Medicine, 4940 Eastern Avenue, Baltimore, MD 21224 USA.
| | - Andrew Cohen
- Brady Urological Institute, Johns Hopkins Medicine, 4940 Eastern Avenue, Baltimore, MD 21224 USA.
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Alberto M, Fernando A, Sewell J, Longano A, Wong P. Obstructed kidney secondary to a benign renal fibroepithelial polyp: A rare and interesting case. Urol Case Rep 2022; 41:101961. [PMID: 34926165 PMCID: PMC8651994 DOI: 10.1016/j.eucr.2021.101961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/24/2021] [Accepted: 11/27/2021] [Indexed: 11/24/2022] Open
Abstract
Renal fibroepithelial polyp (FEP) is a very rare tumour and we describe a case causing acute ureteric obstruction. A 56 year old lady presented with presumed pyelonephritis and left hydronephrosis, without calculi. She was transferred to a tertiary hospital urology service where after an unsuccessful retrograde attempt at stent insertion, a nephrostomy was inserted. Subsequently, the patient underwent a ureteropyeloscopy and excision of a FEP arising from the renal pelvis. Renal FEP is a very rare cause of obstruction and was successfully managed endoscopically.
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11
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Xia W, Chen X, Li B, Chen H, Zhu Z, He Y, Gan Y, Zhang B, Wang K, Li Y, Jiang Z, Long J, Chen Z. Transabdominal Laparoscopic Ureteroureterostomy With the Intraoperative Retrograde Ureteroscopy-Assisted Technique for Multiple Ureteral Polyps: A Single-Center 10 Years Experiences. Front Surg 2022; 9:814290. [PMID: 35284473 PMCID: PMC8913589 DOI: 10.3389/fsurg.2022.814290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 01/21/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe purpose of this study was to report our experience in treating multiple ureteral polyps with transabdominal laparoscopic ureteroureterostomy (LAP-UU) with intraoperative retrograde ureteroscopy (RU)-assisted technique.MethodsThe data of 32 patients who underwent transabdominal LAP-UU with the intraoperative RU-assisted technique due to multiple ureteral polyps between January 2011 and March 2021 were reviewed at our institute. After administration of anesthesia, patients were placed in a passive position and underwent a three-port transabdominal laparoscopy with RU. Detailed data were reviewed, such as demographic characteristics, intraoperative outcomes, postoperative data, complications, and pathology reports.ResultsThirty-two patients were diagnosed with multiple ureteral polyps underwent this surgery method at our institution. The mean duration of symptoms at the time of diagnosis was approximately 7.1 months. The mean age of patients was 42.4 years, with men accounting for 68.8% (22/32), lesion of left for 56.3% (18/32), and the upper ureter for 62.5% (20/32). Furthermore, the median length of the polyps was 3.6 cm, the mean operative time was 174.6 min, and the estimated blood loss (EBL) was about 86.8 ml. The mean time to begin a liquid diet and to be out of bed were 1.7 and 2.3 days, respectively. The average length of hospital stay was 6.3 days. The ureteral stent was removed by cystoscope 2–3 months after surgery. Follow-up duration ranged from 3 to 112 months and none of the patients required another surgery for recurrence.ConclusionTransabdominal LAP-UU combined with the intraoperative RU-assisted technique is an effective, safe, and reliable surgical option for patients with multiple ureteral polyps. Further long-term follow-up is recommended.
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Affiliation(s)
- Weiping Xia
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Xiang Chen
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Bingsheng Li
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Hequn Chen
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Zewu Zhu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yao He
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yu Gan
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Bo Zhang
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Kangning Wang
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yang Li
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Zexiang Jiang
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jin Long
- Department of Urology, The Second Affiliated Hospital, Guizhou Medical University, Kaili, China
| | - Zhi Chen
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Zhi Chen
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Akan S, Ediz C. A rare association in a patient with non-muscle invasive bladder cancer: ureteral fibroepithelial polyp and ipsilateral renal cell carcinoma: a case report. J Med Case Rep 2021; 15:475. [PMID: 34563239 PMCID: PMC8465737 DOI: 10.1186/s13256-021-03070-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 08/19/2021] [Indexed: 11/19/2022] Open
Abstract
Background Fibroepithelial polyps located in the ureter constitute 2–6% of all benign tumors in the urinary system. Distinguishing these lesions from transitional cell carcinoma is essential to avoid unnecessary nephroureterectomy. Case presentation A 59-year-old asymptomatic caucasian male patient was enrolled in follow-up for Ta low-grade transitional cell bladder cancer 4 years ago in our clinic. A suspicious, solid, contrast-enhancing mass 15 × 9 mm in diameter in the anteromedial mid-section of the left kidney, which was causing minimal washout and largely located in the parenchyma, was reported as renal cell carcinoma on computed tomography during routine controls. In the excretory phase, soft-tissue densities of approximately 30 mm in length, which were located in the distal part of the left ureter at a distance of 40 mm from the ureterovesical junction, extending towards the lumen suggested a urethral carcinoma. Urothelial lesion was reported as fibroepithelial polyp after histopathological examination. Partial nephrectomy for the mass, which was reported as renal cell carcinoma in the left kidney, was performed in the first postoperative month. Histopathological examination revealed Fuhrman grade 1 papillary type renal cell carcinoma. No recurrence was observed in the first year after treatment. Conclusions Although our patient had a bladder transitional cell carcinoma and a suspicious renal cell carcinoma mass of 15 mm in the ipsilateral kidney, the patient was safeguarded from unnecessary nephroureterectomy early on by cross-sectional and endoscopic imaging of the ureter.
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Affiliation(s)
- Serkan Akan
- Department of Urology, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.
| | - Caner Ediz
- Department of Urology, University of Health Sciences, Sultan Abdulhamid Han Training and Research Hospital, Tr- 34668, Istanbul, Turkey
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13
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Yamane H, Nishikawa R, Muraoka K. Ureteral fibroepithelial polyp: A case report. Urol Case Rep 2021; 39:101815. [PMID: 34471606 PMCID: PMC8387746 DOI: 10.1016/j.eucr.2021.101815] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 08/19/2021] [Indexed: 11/08/2022] Open
Abstract
Ureteral fibroepithelial polyps are rare, accounting for approximately 2–6% of all ureteral tumors. They can be diagnosed by ultrasonography, computed tomography, and retrograde pyelography; however, diagnosis can be difficult. Management is by resection of the polyp, and endoscopic resection is the standard treatment. Partial ureteral resection and ureteral reconstruction may be necessary depending on the size and location of the polyp. Imaging follow-ups for approximately a year post-surgery are recommended. This clinical case report aimed to highlight a case of a fibroepithelial ureteral polyp that was managed by endoscopic resection.
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Li M, Zhang H, Jiang D, Li L, Liu X, Zhao X, Ye D, Ni Y. Calculus-related functional protein expression in ureteral calculus-adhered polyp: A preliminary study. Medicine (Baltimore) 2021; 100:e26512. [PMID: 34160472 PMCID: PMC8238274 DOI: 10.1097/md.0000000000026512] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 06/09/2021] [Indexed: 01/04/2023] Open
Abstract
To explore the expressions of calculus-related functional proteins in the ureteral calculus-adhered polyp tissues and investigate the role of these proteins in the formation of adhesions between the calculus and polyp.Patients with ureteral calculi and polyps who underwent ureteroscopic lithotripsy for the excision of polyps between January 2019 and June 2019 were enrolled. Polyps obtained from each patient were divided into 2 groups using a matched pairs design: observation group (polyps adhered to calculus) and control group (polyps not adhered to calculus). Histopathological examination of polyps was performed using hematoxylin and eosin staining. Polyp tissues were immunohistochemically stained to assess the expressions of calculus-related functional proteins, that is, annexin A1, calcium-binding protein S100A9 (S100A9), uromodulin, and osteopontin. Furthermore, quantitative analysis was performed using the H-score of tissue staining; Pearson correlation analysis was performed for proteins with high expression.Overall, 40 polyp specimens were collected from 20 patients with ureteral calculi combined with polyps (observation group, 20 specimens; control group, 20 specimens). Hematoxylin and eosin staining revealed obvious epithelial cell proliferation in polyps of both groups; crystals were observed in the epithelial cells of the polyp tissue in the observation group. The expression levels of annexin A1 and S100A9 in the observation group were significantly greater than those in the control group (P < .05). However, no obvious expression of osteopontin or uromodulin was observed in the polyp tissues of both groups. There was a strong correlation between the increased expressions of annexin A1 and S100A9 in the observation group (R = 0.741, P = .022).We documented increased expressions of annexin A1 and S100A9 in the ureteral calculus-adhered polyp tissues. Annexin A1 and S100A9 may play an essential role in the adhesion of calculus and polyp and the growth of calculi.
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15
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George DP, Venkatachalapathy VSS, Abraham GP. Laparoscopic appendicular interposition ureteroplasty for mid-ureteral defect. Indian J Urol 2021; 37:189-190. [PMID: 34103807 PMCID: PMC8173952 DOI: 10.4103/iju.iju_117_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 07/14/2020] [Accepted: 10/11/2020] [Indexed: 11/04/2022] Open
Abstract
Patients with ureteral defects and salvageable renal units present a challenge in reconstructive urology. Vermiform appendix interposition is an option in the management of mid-ureteral defects that can not be managed by primary ureteroureterostomy. Laparoscopic appendicular interposition ureteroplasty is a technically demanding and an infrequently attempted procedure. We present a video demonstration of laparoscopic appendicular interposition for a 4-cm long right mid-ureteral defect in an elderly male. Laparoscopic appendicular interposition ureteroplasty for mid-ureteral defects can provide good long-term functional outcomes with results comparable to an open approach and has the advantage of reduced morbidity.
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16
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Mixed epithelial and stromal tumor of the kidney extending to the proximal ureter in a 41-year-old female. Urol Case Rep 2021; 38:101731. [PMID: 34141585 PMCID: PMC8187956 DOI: 10.1016/j.eucr.2021.101731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/18/2021] [Accepted: 05/25/2021] [Indexed: 11/29/2022] Open
Abstract
We report the case of a 41-year-old pregnant female who presented with a complicated urinary tract infection. Further imaging revealed left hydronephrosis and filling defects extending from the proximal ureter to the upper pole of the kidney, with the presumed diagnosis of a fibroepithelial polyp. The patient underwent a four-stage percutaneous and ureteroscopic ablation and resection. Following the procedure, pathology instead confirmed the presence of a Mixed Epithelial and Stromal Tumor of the Kidney. For lesions that extend intraluminally into the ureters, a ureteroscopic and percutaneous resection can be considered as an alternative surgical approach. Ureteral mass presumed fibroepithelial polyp given location and presentation. Histology confirmed mixed epithelial and stromal tumor of the kidney. Mixed epithelial and stromal tumor of the kidney extending to proximal ureter. Endoscopic management chosen given location of the intraluminal ureteral lesion.
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17
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Sun ZW, Ge JK, Wu Y, Huang YQ. Ureteral polyps protruding from the urethra. BMC Urol 2021; 21:22. [PMID: 33568095 PMCID: PMC7877100 DOI: 10.1186/s12894-021-00786-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 01/26/2021] [Indexed: 12/26/2022] Open
Abstract
Background Ureteral fibro-epithelial polyp (UFP) is a rare benign ureteral tumor, and surgical removal of the polyps is still the preferred solution. Although many cases have reported polyps extending to the bladder, our case was the first to report a huge UFP that underwent endoscopic laser resection to highlight the urethra and cause severe end hematuria permanently. Case presentation In 2019, a 37-year-old woman came to the hospital because of hematuria and a dark red extraurethral mass. CTU inspection showed: filling defect between the right ureter and the bladder at the entrance of the bladder. After ureteroscopy, it was found that the ureteral mass came out of the urethral orifice. Then, under the direct view of the ureteroscope, a Ho:YAG laser was used to remove the tumor by cutting off along the its base, and the patient was discharged 3 days after the operation. Conclusion Urethral polyps from the ureter should be considered in the differential diagnosis of urethral neoplasms. Ho:YAG laser resection under ureteroscopy is an effective option for treating UFP, but be careful of ureteral stricture after surgery.
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Affiliation(s)
- Zhi-Wei Sun
- Department of Urology, Affiliated Hospital of Nantong University, No. 20 Xisi Road, Nantong, China
| | - Jian-Kang Ge
- Department of Urology, Affiliated Hospital of Nantong University, No. 20 Xisi Road, Nantong, China
| | - You Wu
- Department of Urology, Affiliated Hospital of Nantong University, No. 20 Xisi Road, Nantong, China
| | - Ye-Qing Huang
- Department of Urology, Affiliated Hospital of Nantong University, No. 20 Xisi Road, Nantong, China.
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18
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Rousseau S, Peycelon M, Grosos C, Bidault V, Poupalou A, Martin G, Dobremez É, Harper L, Raquillet C, Arnaud A, Sapin E, Scalabre A, Buisson P, Levard G, Pommepuy I, Pons M, Fourcade L, Ballouhey Q. Management of lower urinary tract fibroepithelial polyps in children. J Pediatr Surg 2021; 56:332-336. [PMID: 32641248 DOI: 10.1016/j.jpedsurg.2020.05.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/07/2020] [Accepted: 05/11/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Fibroepithelial polyps (FEP) of the lower urinary tract are relatively common in adults but rare in children, with fewer than 250 cases reported in the literature to date. OBJECTIVE The aim of this study was to address the experience of FEP management in children. STUDY DESIGN A retrospective multicenter review was undertaken in children with defined FEP of the lower urinary tract managed between 2008 and 2018. The data at 18 pediatric surgery centers were collected. Their demographic, radiological, surgical, and pathological information were reviewed. RESULTS A total of 33 children (26 boys; 7 girls) were treated for FEP of the lower urinary tract at 13 centers. The most common presentation was urinary outflow as hematuria (41%), acute urinary retention (25%), dysuria (19%), or urinary infections (28%). A prenatal diagnosis was made for three patients with hydronephrosis. Almost all of the children (94%) underwent ultrasound imaging of the urinary tract as the first diagnostic examination, 23 (70%) of them also either had an MRI (15%), cystourethrography (25%), computerized tomography (6%), or cystoscopy (45%). Two of these children (6%) had a biopsy prior to the surgery. The median preoperative delay was 7.52 (range: 1-48) months. Most of the patients were treated endoscopically, although four (12.1%) had open surgery and two (6.1%) had an additional incision for specimen extraction. The median hospital stay was 1.5 (range: 1-10) days. There were no recurrences and no complications after a median follow-up of 13 (range: 1-34) months. DISCUSSION The main limitation of our study is the retrospective design, although it is the largest one for this pathology. CONCLUSION This series supports sonography as the most suitable diagnosis tool before endoscopy to confirm the diagnosis and to perform the resection for most FEP in children. This report confirms the recognized benign nature in the absence of recurrences. LEVEL OF EVIDENCE Level V.
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Affiliation(s)
- Sybille Rousseau
- Service de chirurgie pédiatrique, Hôpital Mère-Enfant, Centre Hospitalier Universitaire de Limoges, 8 Avenue Dominique Larrey 87042, Limoges, France
| | - Matthieu Peycelon
- Service de chirurgie et urologie pédiatrique, Hôpital Universitaire Robert-Debré, APHP - Centre de Référence Maladies Rares « MARVU », Université de Paris, Paris, France; Pediatric Urology, Riley Children's Hospital, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Céline Grosos
- Service de chirurgie pédiatrique, Hôpital Mère-Enfant, Centre Hospitalier Universitaire de Limoges, 8 Avenue Dominique Larrey 87042, Limoges, France
| | - Valeska Bidault
- Service de chirurgie et urologie pédiatrique, Hôpital Universitaire Robert-Debré, APHP - Centre de Référence Maladies Rares « MARVU », Université de Paris, Paris, France
| | - Anna Poupalou
- Service de Chirurgie Pédiatrique, Hôpital HUDERF-ST Pierre (Université Libre de Bruxelles-ULB), Brussels, Belgium
| | - Garance Martin
- Service de chirurgie pédiatrique, Hôpital Trousseau, Paris, France
| | - Éric Dobremez
- Service de chirurgie pédiatrique, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Luke Harper
- Service de chirurgie pédiatrique, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Claire Raquillet
- Service de chirurgie pédiatrique, Centre Hospitalier Ballanger, Aulnay-sous-Bois, France
| | - Alexis Arnaud
- Service de chirurgie pédiatrique, Centre Hospitalier Universitaire de Rennes, Bordeaux, France
| | - Emmanuel Sapin
- Service de chirurgie pédiatrique, Centre Hospitalier Universitaire de Dijon, Bordeaux, France
| | - Aurélien Scalabre
- Service de chirurgie pédiatrique, Centre Hospitalier Universitaire de Saint Etienne, Bordeaux, France
| | - Philippe Buisson
- Service de chirurgie pédiatrique, Centre Hospitalier Universitaire d'Amiens, Bordeaux, France
| | - Guillaume Levard
- Service de chirurgie pédiatrique, Centre Hospitalier Universitaire de Poitiers, Bordeaux, France
| | - Isabelle Pommepuy
- Service d'anatomo-pathologie, Centre Hospitalier Universitaire de Limoges, Bordeaux, France
| | - Maguelonne Pons
- Service de chirurgie pédiatrique, Centre Hospitalier Universitaire de Clermont-Ferrand, Bordeaux, France
| | - Laurent Fourcade
- Service de chirurgie pédiatrique, Hôpital Mère-Enfant, Centre Hospitalier Universitaire de Limoges, 8 Avenue Dominique Larrey 87042, Limoges, France
| | - Quentin Ballouhey
- Service de chirurgie pédiatrique, Hôpital Mère-Enfant, Centre Hospitalier Universitaire de Limoges, 8 Avenue Dominique Larrey 87042, Limoges, France.
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19
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Gao H, Chen J, Li G, Cui X, Sun F. Experience Summary of Laparoscopic Treatment for Pediatric Ureteral Polyps. Front Pediatr 2021; 9:689842. [PMID: 34277523 PMCID: PMC8278000 DOI: 10.3389/fped.2021.689842] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 06/03/2021] [Indexed: 01/28/2023] Open
Abstract
Objective: To investigate surgical techniques and challenges of laparoscopic in treating pediatric ureteral polyps under laparoscopy. Methods: The clinical data of 7 of pediatric ureteral polyps patients who were admitted to the hospital from July 2015 to January 2020 were analyzed retrospectively. There were 6 males and 1 female from 7.7 to 13.9 years old at the mean age of 10.4. Before surgery, all children performed urinary B ultrasound, magnetic resonance urography (MRU), and renal radionuclide scanning. Six cases were observed on the left lateral and 1 on the right. The lesions of 5 cases were located at the ureteropelvic junction, 1 in the upper ureter and 1 in the middle ureter. The polyps were treated intraoperatively by the resecting of the lesion segment and simple polypectomy to retain the attached part of the original diseased segment of the ureter. All surgeries were performed under laparoscopy and B-ultrasound was performed during follow up after surgery. Results: All 7 surgeries were performed successfully under the laparoscope. The surgery time was 80-110 min, and the average surgery time was 97.5 min. The intraoperative bleeding was 10-25 ml and the average postoperative hospital stay was 6 d. Postoperative hematuria occurred in 1 case. Neither urinary leakage nor urinary tract infection was reported post surgery. Preoperative affected pyelectasis of all patients was 2.0-3.7 cm. Three months postoperatively, the affected pyelectasis was measured at 1.2-3.0 cm. No recurrence of polyps was reported after surgery. During the follow-up to April 2020, there was no significant change in the kidney size of all patients, and hydronephrosis was alleviated compared with that before surgery. Conclusions: Laparoscopy is a safe, effective and minimally invasive surgical technique for pediatric multiple ureteral polyps. The surgery plan was designed according to the location and size of polyps, including segmental ureterectomy of polyps + pyeloureterostomy, segmental ureterectomy of polyps + ureter - ureteral anastomosis.
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Affiliation(s)
- Hongjie Gao
- Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, China
| | - Jiawei Chen
- Department of Pediatric Surgery, Qilu Hospital of Shandong University, Jinan, China
| | - Guowei Li
- Department of Pediatric Surgery, Qilu Hospital of Shandong University, Jinan, China
| | - Xinhai Cui
- Department of Pediatric Surgery, Qilu Hospital of Shandong University, Jinan, China
| | - Fengyin Sun
- Department of Pediatric Surgery, Qilu Hospital of Shandong University, Jinan, China
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20
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A Novel Technique for Management of Simultaneous Fibro-Epithelial Polyp and Blind-Ending Branch in a Duplicated Ureter: A Case Report With 23-year Follow-Up. Urology 2020; 149:e5-e7. [PMID: 33333141 DOI: 10.1016/j.urology.2020.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 11/30/2020] [Accepted: 12/03/2020] [Indexed: 11/21/2022]
Abstract
Ureteral duplication with a blind-ending branch (BEB) is rare anomaly. The presence of fibro-epithelial polyps in duplicated ureters is also infrequent. Despite the noticeability of endoscopic polypectomy, further recurrence of polyps and persistence of pain increase the probability of further ureteral resection with surgical procedures. In such cases, BEB of duplicated ureter is an excellent reservoir to save the function of the kidney. This is the first case with concomitant presence of fibro-epithelial polyps and BEB in duplicated ureter managed with novel surgical technique of uretero-pelvic junction and BEB branch anastomosis. We followed-up the patient for 23 years.
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21
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Gross AR, Stencel M, Hale N, Naturale R. Robotic resection of a fibroepithelial polyp arising in the setting of nephrolithiasis. Urol Case Rep 2020; 34:101449. [PMID: 33102130 PMCID: PMC7575840 DOI: 10.1016/j.eucr.2020.101449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/05/2020] [Accepted: 10/11/2020] [Indexed: 11/18/2022] Open
Abstract
Though rare, fibroepithelial polyps of the ureter consistently present with symptoms such as flank discomfort and may lead to renal failure. This often affects young adults and characteristically arises in the proximal ureter. The pathogenesis is unclear. Flank pain is the most common presenting symptom, which may create diagnostic confusion. Indeed, resection provides lasting relief which otherwise may elude patients who receive other treatments. Resection modality may be selected on a patient-by-patient basis. Here we present a case in which flank pain, and historical episodes of abdominal pain, were resolved by excision of a fibroepithelial polyp by a robotic assisted laparoscopic approach.
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Affiliation(s)
- Alexander R. Gross
- PO Box MS 9203, WVU Department of Pathology, Anatomy and Laboratory Medicine, 64 Medical Center Drive, Morgantown, WV, 26506, USA
- Corresponding author.
| | - Michael Stencel
- Charleston Area Medical Center, Department of Urology, 3100 MacCorkle Avenue SE Suite 602, Charleston, WV, 25304, USA
| | - Nathan Hale
- Charleston Area Medical Center, Department of Urology, 3100 MacCorkle Avenue SE Suite 602, Charleston, WV, 25304, USA
| | - Richard Naturale
- Charleston Area Medical Center, Department of Pathology, 3200 MacCorkle Avenue SE, Charleston, WV, 25301, USA
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22
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He M, Li N, Zhang W, Ren Z. Preoperative diagnosis, treatment, and outcomes of FEPs of ureters in children: a 13-year retrospective study based on data at a large pediatric medical center. World J Urol 2020; 39:2239-2243. [PMID: 32844353 PMCID: PMC8217005 DOI: 10.1007/s00345-020-03379-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 07/20/2020] [Indexed: 11/12/2022] Open
Abstract
Purpose To describe our experience in handling cases of children with fibroepithelial polyps (FEPs) of ureters. We specifically present preoperative diagnosis approaches, provide a clear definition of this entity and its outcomes following treatment. Method Clinical data of children with FEPs who were consecutively treated at Beijing Children's Hospital from January 2006 to May 2019 were retrospectively analyzed in this study. The clinical data reviewed included diagnostic, intraoperative, and follow-up data. Results Of the 2653 children with surgery for hydronephrosis reviewed, 48 (1.8%) cases of FEPs of the ureters were identified, with a mean age of 109 ± 34.7 months. Among them, males accounted for 95.8%, left side for 81.3%, and proximal ureteral polyps for 97.9%. Notably, 70.8% of patients had only 1 polyp and the median size of the polyps was 2.1 ± 1.8 cm. All patients underwent ultrasound before surgery, which revealed the existence of polyps in 29 (60.4%) children. These polyps were completely resected surgically. The mean follow-up was 82 months (range of 6–153 months) and no cases of recurrences of polyps were seen after surgery during follow-up. The rate of other long-term complications was 9.3%. Conclusions In conclusion, FEPs are one of the important causes of hydronephrosis in children. Ultrasound is effective for preoperative diagnosis achieving higher true positive rates than other diagnostic methods. Although the recurrence rate of polyps and symptoms are low after complete resection in children, long-term follow-up is advocated to the adolescence stage to monitor the incidences of urinary tract infections, ureteropelvic junction obstruction and stone formation. Electronic supplementary material The online version of this article (10.1007/s00345-020-03379-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Meng He
- Department of Urology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Nan Li Shi Lu Street No. 56, Beijing, 100045, China
| | - Ning Li
- Department of Urology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Nan Li Shi Lu Street No. 56, Beijing, 100045, China.
| | - Weiping Zhang
- Department of Urology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Nan Li Shi Lu Street No. 56, Beijing, 100045, China.
| | - Zhentao Ren
- Department of Urology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Nan Li Shi Lu Street No. 56, Beijing, 100045, China
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23
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Hamamoto S, Okada S, Inoue T, Sugino T, Unno R, Taguchi K, Ando R, Okada A, Miura H, Matsuda T, Yasui T. Prospective evaluation and classification of endoscopic findings for ureteral calculi. Sci Rep 2020; 10:12292. [PMID: 32704036 PMCID: PMC7378819 DOI: 10.1038/s41598-020-69158-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 07/03/2020] [Indexed: 12/16/2022] Open
Abstract
Difficulty in performing ureteroscopic lithotripsy (URSL) depends on endoscopic findings surrounding calculi. In this multicentre prospective cohort study of 185 patients with a single ureteral stone who underwent ureteroscopic lithotripsy registered in the SMART study between January 2014 and February 2017, we established a classification of endoscopic findings and analysed risk factors for ureteral changes. We evaluated endoscopic findings (oedema, polyps, ureteral mucosa-stone adherence, and distal ureteric tightness) based on the SMART classification. Operative time and ureteral injuries were significantly correlated with endoscopic finding grades. Multivariate analyses revealed that mucosa-stone adherence (MSA) was strongly affected by hydronephrosis grade (odds ratio, 12.4; p = 0.022) and the interval before surgery (odds ratio, 1.10; p = 0.012). The cutoff value for MSA was 98 days, with a predictive accuracy of 0.78. Risk factors for distal ureteric tightness were age (odds ratio, 0.96; p = 0.004) and early intervention (odds ratio, 0.90; p = 0.023). The cutoff value was 34 days, with a predictive accuracy of 0.72. In conclusion, appropriate intervention around 34 days (limited to 98 days) after symptom onset is necessary for treating ureteral calculi. Even if intervention passed 98 days post-symptom onset, staged URSL, alternative procedures, and detailed informed consent should be planned in advance, assuming strong MSA.
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Affiliation(s)
- Shuzo Hamamoto
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shinsuke Okada
- Department of Urology, Gyotoku General Hospital, Hongyotoku 5525-2, Ichikawa City, Chiba, Japan.
| | - Takaaki Inoue
- Department of Urology, Hara Genitourinary Hospital, Hyogo, Japan
| | - Teruaki Sugino
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Rei Unno
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kazumi Taguchi
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Ryosuke Ando
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Atsushi Okada
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hiroyasu Miura
- Department of Urology, Hachinohe Koyo Clinic, Aomori, Japan
| | - Tadashi Matsuda
- Department of Urology and Andrology, Kansai Medical University, Osaka, Japan
| | - Takahiro Yasui
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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24
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Köseoğlu H, Eroğlu T, Akdemir C, Turan H, Leblebici C. Incidental ureteral fibroepithelial polyp. Proc (Bayl Univ Med Cent) 2020; 33:684-685. [PMID: 33100571 DOI: 10.1080/08998280.2020.1783968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Although rare, fibroepithelial polyp of the ureter is the most common type of benign urinary tract mesodermal tumor. It may cause symptoms such as hematuria, dysuria, and flank pain or be asymptomatic. Here we report incidental intraoperative detection of a left ureteral fibroepithelial polyp during an elective gyno-oncological surgery for left-sided ovarian thecoma.
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Affiliation(s)
- Hikmet Köseoğlu
- Department of Urology, Health Sciences University, Istanbul Education & Research Hospital, Istanbul, Turkey
| | - Tolga Eroğlu
- Department of Urology, Health Sciences University, Istanbul Education & Research Hospital, Istanbul, Turkey
| | - Celal Akdemir
- Department of Gynecology & Obstetrics, Health Sciences University, Istanbul Education & Research Hospital, Istanbul, Turkey
| | - Hasan Turan
- Department of Gynecology & Obstetrics, Health Sciences University, Istanbul Education & Research Hospital, Istanbul, Turkey
| | - Cem Leblebici
- Department of Pathology, Health Sciences University, Istanbul Education & Research Hospital, Istanbul, Turkey
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25
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Alhindi S, Alaradi H, Mubarak M. Fibroepithelial Polyp in a Child: A Rare Pathology of Upper Urinary Tract Obstruction. Cureus 2020; 12:e8748. [PMID: 32714686 PMCID: PMC7377021 DOI: 10.7759/cureus.8748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Fibroepithelial polyp is a rare benign tumor of the urothelial system that originates from the mesoderm. Polyps are usually small and located in the upper urinary tract and ureteropelvic junction. However, in the pediatric population, such polyps are more common in the posterior urethra and will present with symptoms of urinary tract obstruction. Some will present with flank pain and hematuria, resembling symptoms of ureteric stones. In this case, we discuss a nine-year-old boy presenting with complaints of flank pain and hematuria for one year. Following laboratory and radiological investigations, the left ureter was dilated at the mid-lumbar region with an anteroposterior diameter of 2.3 x 0.6 cm and a left renal pelvis anteroposterior diameter of 2.2 cm. An ultrasound scan identified an intraluminal lesion suspected to be a fibroepithelial polyp. Management was carried out via retroperitoneal surgery with upper ureteral resection and end-to-end anastomosis. Postoperatively, the patient’s symptoms improved, and a subsequent ultrasound scan and renal function test showed improvement of the left hydroureter and hydronephrosis.
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Affiliation(s)
- Saeed Alhindi
- Pediatric Surgery, Salmaniya Medical Complex, Manama, BHR
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26
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Bansal D, Maheshwari R, Chaturvedi S, Kumar A. Giant ureteral fibro-epithelial polyp: A rare but important differential of ureteral urothelial cell carcinoma. JOURNAL OF CLINICAL UROLOGY 2020. [DOI: 10.1177/2051415820931629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Fibro-epithelial polyps (FEPs) of the ureter are rare benign tumours and constitute an important differential for ureteral urothelial cell carcinoma (UCC). Case presentation: We describe a case of a 56-year-old lady presenting with gross haematuria. On initial evaluation elsewhere, she was diagnosed with lower ureteric UCC and was advised left nephroureterectomy. Careful evaluation at our centre established the diagnosis of a left ureteral FEP. Robot-assisted excision of the ureteral FEP was successfully done. Conclusion: Diagnosis of these rare tumours may be made with a combination of imaging, ureteroscopy and histopathological analysis. Resection of giant FEPs may be done with a robot-assisted technique. Proper diagnosis and management of these tumours are essential to avoid unnecessary nephroureterectomies. Level of evidence: 4
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Affiliation(s)
- Devanshu Bansal
- Department of Urology, Uro-oncology, Robotics and Renal Transplant, Max Group of Hospitals, Delhi and NCR, India
| | - Ruchir Maheshwari
- Department of Urology, Uro-oncology, Robotics and Renal Transplant, Max Group of Hospitals, Delhi and NCR, India
| | - Samit Chaturvedi
- Department of Urology, Uro-oncology, Robotics and Renal Transplant, Max Group of Hospitals, Delhi and NCR, India
| | - Anant Kumar
- Department of Urology, Uro-oncology, Robotics and Renal Transplant, Max Group of Hospitals, Delhi and NCR, India
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27
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Kumar L, Kumar S, Dogra PN, Kaushal S, Panaiyadiyan S, Jain S, Kumar M. Robotic Excision of Upper Ureteral Fibroepithelial Polyp Presenting as Pelviureteral Junction Obstruction: Surgical Surprise with Review of Literature. J Endourol Case Rep 2020; 6:30-34. [PMID: 32775670 DOI: 10.1089/cren.2019.0088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Fibroepithelial polyps in the upper ureter are a rare cause of pelviureteral junction obstruction (PUJO). Its diagnosis usually remains challenging by clinical and radiologic means. Case Presentation: We discuss a case of 19-year-old boy who present with intermittent left flank pain. Radiologic imaging suggested diagnosis of PUJO. We planned for robotic pyeloplasty. Intraoperatively pelviureteral junction (PUJ) was dependent, nonstenotic with upper hydroureteronephrosis creating suspicion of polyp. Keeping suspicion of polyp in upper ureter, we did robotic upper ureterotomy. This procedure revealed a 1 × 1 cm benign polyp at PUJ, which was excised completely. Conclusion: Polyps in the upper ureter constitute uncommon clinical cause of PUJO and usually diagnosed intraoperatively. Robotic approach is a feasible, acceptable, and safe option in such clinical scenario. It provides all the benefits of minimal invasive surgical procedures.
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Affiliation(s)
- Lalit Kumar
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjay Kumar
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India
| | - Prem Nath Dogra
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Kaushal
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Sridhar Panaiyadiyan
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India
| | - Siddharth Jain
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India
| | - Manoj Kumar
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India
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28
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Abdessater M, Kanbar A, Khoury JE, Hachem CE, Halabi R, Boustany J, Khoury RE. Endourologic treatment for a fibroepithelial ureteral polyp protruding from the urethra. J Surg Case Rep 2019; 2019:rjz320. [PMID: 31737246 PMCID: PMC6846958 DOI: 10.1093/jscr/rjz320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 10/01/2019] [Indexed: 11/16/2022] Open
Abstract
Fibroepithelial polyps (FP) of the ureter are rare and benign mesodermal tumors frequently mistaken for transitional cell carcinoma. We hereby report a rare case of a 19-year-old patient with two FPs, originating from the distal left ureter that were successfully treated with ureteroscopy. One of these polyps was completely protruding outside the bladder through the urethra, which makes this case unique in the literature. Ureteroscopy is currently the best method available for identification, histologic diagnosis and treatment of these polyps.
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Affiliation(s)
- Maher Abdessater
- Notre Dame des Secours-University Medical Center, Byblos, Lebanon.,Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Anthony Kanbar
- Notre Dame des Secours-University Medical Center, Byblos, Lebanon.,Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Joey El Khoury
- Notre Dame des Secours-University Medical Center, Byblos, Lebanon.,Holy Spirit University of Kaslik, Jounieh, Lebanon
| | | | - Rami Halabi
- Notre Dame des Secours-University Medical Center, Byblos, Lebanon.,Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Johnny Boustany
- Notre Dame des Secours-University Medical Center, Byblos, Lebanon.,Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Raghid El Khoury
- Notre Dame des Secours-University Medical Center, Byblos, Lebanon.,Holy Spirit University of Kaslik, Jounieh, Lebanon
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29
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Graff J, Patnaik S, Cohen T, Memo M. Ureteral Polyp Managed by Endoscopic Techniques. Rev Urol 2019; 21:45-48. [PMID: 31239832 PMCID: PMC6585181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Fibroepithelial polyps (FEPs) are rare benign tumors of mesodermal origin. They are found in the ureters 85% of the time, with the remainder located in the renal pelvis and occasionally the bladder. FEPs can present as flank pain, lower abdominal pain, and/or gross hematuria. Previous literature reports management of these benign lesions using open surgical techniques, laparoscopic techniques, and endoscopic management. In this article, the authors present their pure endoscopic management of a large ureteral polyp and a review of the current literature outlining the etiology, clinical presentations, and management techniques for FEP of the ureter.
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Affiliation(s)
- John Graff
- Northeast Ohio Medical University Rootstown, OH
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30
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Hajji F, Moufid K, Ghoundale O, Touiti D. A rare case of successful endoscopic management of a fibroepithelial polyp with intussusception of the ureter and periodic prolapse into bladder. Ann R Coll Surg Engl 2018; 101:e66-e70. [PMID: 30421620 DOI: 10.1308/rcsann.2018.0198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Fibroepithelial polyps of the ureter are rare non-epithelial benign tumours with a slight female predominance. They are primarily located in the upper left ureter, incidentally diagnosed in patients who are evaluated for gross haematuria or renal colic. Fibroepithelial polyps are traditionally managed by open surgery with resection of the polyp and its stalk or partial resection of the ureter. We describe the case of a fibroepithelial polyp located in the distal right ureter, which occurred in a 42-year-old man with lower urinary tract symptoms, haematuria and flank pain. To our knowledge, this is the first reported case of ureteral fibroepithelial polyp acting as a lead point for ureteral intussusception and to protruding periodically into the bladder cavity, which was successfully resected by ureteroscopic electrocauterisation with good outcome.
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Affiliation(s)
- F Hajji
- Department of Urology, Ibn Sina Military Hospital , Marrakech , Morocco
| | - K Moufid
- Department of Urology, Ibn Sina Military Hospital , Marrakech , Morocco
| | - O Ghoundale
- Department of Urology, Ibn Sina Military Hospital , Marrakech , Morocco
| | - D Touiti
- Department of Urology, Ibn Sina Military Hospital , Marrakech , Morocco
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31
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Cao Y, Chen Q, Zhong H, Xuan HQ, Xia L, Xue W. Treatment of large fibroepithelial polyps in the proximal ureter with antegrade plus retrograde endoscopic laser polypectomy. Medicine (Baltimore) 2018; 97:e11747. [PMID: 30095629 PMCID: PMC6133639 DOI: 10.1097/md.0000000000011747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
The diagnosis and treatment of large fibroepithelial polyps in the proximal ureter have been the clinical challenges. This study retrospectively summarized the clinical diagnosis and treatment of fibroepithelial polyps >5 cm in length in the proximal ureter of 6 patients who received treatment in the Affiliated Renji Hospital of Shanghai Jiaotong University School of Medicine between December 2010 and February 2017. The length of fibroepithelial polyps ranged from 5.8 to 8.2 cm. There were 4 males and 2 females with the mean age of 32.6 ± 9.8 years. Unilateral polyps were found in all patients (right: n = 4; left: n = 2). Hydronephrosis of different extents was noted in these patients, 4 complained of back pain and 2 were diagnosed with hydronephrosis by ultrasonography. 1 patient had macroscopic hematuria. All these patients received antegrade plus retrograde endoscopic laser polypectomy after admission. Symptoms were significantly improved after surgery, and ultrasonography showed hydronephrosis was attenuated to different extents 2 weeks later. Three months later, computed tomography urography revealed favorable recovery in 5 patients and deterioration of hydronephrosis due to ureteropelvic stenosis in 1 patient.
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32
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Ten Donkelaar CS, Houwert AC, Ten Kate FJW, Lock MTWT. Polypoid arteriovenous malformation of the ureter mimicking a fibroepithelial polyp, a case report. BMC Urol 2017; 17:55. [PMID: 28693464 PMCID: PMC5504856 DOI: 10.1186/s12894-017-0237-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 06/19/2017] [Indexed: 11/24/2022] Open
Abstract
Background Arteriovenous malformations (AVM) of the urinary tract are extremely rare. To the best of our knowledge, only three case of AVM of the ureter have been described in the literature so far. Case presentation We present an additional, fourth case of an AVM of the ureter, clinically presented as asymptomatic haematuria and an obstructive process in the left ureter. Ureteroscopic evaluation revealed a fibroepithelial polypoid-like lesion in the proximal ureter. After biopsy showed a benign lesion, the lesion was treated with the 2-μm continuous wave (cw) thulium laser. Histopathological examination revealed a polypoid laesion caused by a circumscribed arteriovenous malformation. Almost four years after operation the patient remains asymptomatic and free of recurrence. Conclusion Arteriovenous malformations of the urinary tract are extremely rare. We presented a fourth case of a arteriovenous malformation of the ureter. Electronic supplementary material The online version of this article (doi:10.1186/s12894-017-0237-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- C S Ten Donkelaar
- University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
| | - A C Houwert
- University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - F J W Ten Kate
- University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - M T W T Lock
- University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
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33
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El-Haress M, Ghandour W, Bahmad M, Fakhruddin N, Fawaz H, Bahmad H. Giant Ureteral Fibroepithelial Polyp with Intermittent Prolapse Reaching the Urethral Meatus: A Case Report. Urol Case Rep 2017; 13:6-9. [PMID: 28417075 PMCID: PMC5388910 DOI: 10.1016/j.eucr.2017.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 03/09/2017] [Accepted: 03/16/2017] [Indexed: 11/19/2022] Open
Abstract
Ureteral fibroepithelial polyps (UFPs) are rare non-epithelial benign tumors of the urinary tract. Treatment of such cases ranges from conservative management to surgical resection of the polyp. Hereby, we present a rare case of a 37-year-old female patient with giant 14 cm UFP of the distal left ureter, successfully resected by ureteroscopic electrocauterization. Several cases of UFPs have been previously reported in world literature describing polyps extending into the bladder; yet, our case is the first to present a giant UFP that extends beyond the bladder cavity protruding outside the urethral meatus as a red fleshy mass.
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Affiliation(s)
| | - Wael Ghandour
- Department of Urology, Hammoud Hospital University Medical Center, Saida, Lebanon
| | - Marwan Bahmad
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon.,Department of General Surgery, Hammoud Hospital University Medical Center, Saida, Lebanon
| | - Najla Fakhruddin
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon.,Department of Pathology, Hammoud Hospital University Medical Center, Saida, Lebanon
| | - Hussein Fawaz
- Department of Urology, Hammoud Hospital University Medical Center, Saida, Lebanon
| | - Hisham Bahmad
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon
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34
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Cai Y, Zhang Z, Yue X. Rare giant primary ureteral polyp: A case report and literature review. Mol Clin Oncol 2017; 6:327-330. [PMID: 28451407 PMCID: PMC5403350 DOI: 10.3892/mco.2017.1146] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 01/31/2017] [Indexed: 12/03/2022] Open
Abstract
Primary ureteral fibroepithelial polyps (UFPs) are rare benign tumors of mesodermal origin. The majority UFPs are observed in the proximal part of the ureter and most commonly on the left side. The mean diameter of UFP is reported to be <5 cm. We herein present a rare case of a long primary ureteral polyp originating from the lower ureter in a 53-year-old woman. Following computed tomography, magnetic resonance imaging, retrograde pyelography and ureteroscopic examination, a preliminary diagnosis of giant primary lower ureteral polyp protruding into the bladder was obtained. Polyp resection and resection of the narrow ureteral segment with a V-shaped end-to-end anastomosis were performed. The length of this polyp was 15.0 cm, and the final pathological diagnosis was UFP. No recurrence or ureteral stenosis were observed at the 12-month follow-up. A supplementary review of previously published cases and related literature is also included.
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Affiliation(s)
- Yunlin Cai
- Department of Urology, The Second Clinical Hospital of North Sichuan Medical College (Nanchong Central Hospital), Nanchong, Sichuan 637000, P.R. China
| | - Zongping Zhang
- Department of Urology, The Second Clinical Hospital of North Sichuan Medical College (Nanchong Central Hospital), Nanchong, Sichuan 637000, P.R. China
| | - Xiaofeng Yue
- Department of Urology, The Second Clinical Hospital of North Sichuan Medical College (Nanchong Central Hospital), Nanchong, Sichuan 637000, P.R. China
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