Polyps of the posterior urethra in children

Congenital urethral polyps in children: report of 18 patients and review of literature

BACKGROUND/PURPOSE

To evaluate the presentation, diagnosis and management of congenital urethral polyps (CUP) in children and to report the results of the endoscopic resection of polyp with long-term follow-up.

METHODS

Between April 1995 to March 2010, 18 children (14 boys, 4 girls) with CUP were treated. The most common presentation was urinary outflow obstruction/retention, hematuria or protruding polyp from the urethra meatus in girls. Six patients presented with vesicoureteral reflux (VUR). All children (except one) underwent a transurethral resection of the CUP.

RESULTS

Following the endoscopic resection of the polyps, there was no polyp recurrence, and all patients became symptom-free. The children exhibited no reflux, urinary retention, hematuria or urinary tract infection (UTI) following endoscopic management. Abnormal uroflowmetry patterns returned to normal following the resection of the polyp for one year after the operation.

CONCLUSIONS

Urethral polyps must be considered in every child with history of triad of recurrent intermittent urinary retention, hematuria and lower urinary tract symptoms. The cure can be achieved in all cases by an endoscopic approach. This type of tumor is always benign and very rarely recurs, unless the pedicle stalk is not resected. The endoscopic management of reflux is unnecessary in this group of patients due to their natural history of secondary reflux.

Papillary adenomas of prostatic urethra with ultrastructural histogenetic considerations

Benign urethral lesions are rather uncommon, and relatively few cases have been described in the literature. Malignant neoplasms, such as squamous and transitional cell carcinomas, occur more frequently. The latter usually present as papillary lesions. Specifically, papillary adenomas of the prostatic urethra are very unusual and rare lesions. They are usually seen in children but occasionally are found in the adult. Symptoms include urinary obstruction, infection, enuresis, sexual disturbances, or hematuria. Two cases of papillary adenomas are presented in this article. The lesion is important because it can be a source of significant hematuria, but can be cured easily at cystoscopy by local excision. This article describes the electron microscopic findings in two of these tumors, trying to elucidate their histogenesis and nature. No ultrastructural studies of these lesions have been reported previously.

Polyps and papillary lesions of the prostatic urethra

There is confusion over the type and nature of polypoid and papillary lesions of the prostatic urethra. These are uncommon growths which may present clinically with hematuria, frequency, obstruction or hematospermia. Pathologically, they usually occur in the region of the verumontanum and show papillary epithelial overgrowth. There is much variation in the terminology applied to such lesions, and many different theories of histogenesis have been advanced. Both benign and malignant lesions may occur. Two cases, one benign and one malignant, are described. The literature is reviewed and a rational nomenclature and histogenesis are proposed.

Transurethral resection of pedunculated congenital polyps of the posterior urethra

Congenital posterior urethral polyps are rare, benign tumours. Five cases are reported, in ages ranging from 2 to 46 years. All were treated by transurethral resection and we would recommend that, since suitable endoscopic equipment is now available, this is the treatment of choice.

Villous polyps of the urethra: a report of two cases

Two patients with villous polyps of the prostatic urethra are described. The article supports previous observations that the lesion has the morphologic appearance of prostatic tissue. A review of the literature reveals that this rare lesion appears to be specific for the prostatic urethra and behaves as a benign tumor.

Fibroepithelial polyp of the verumontanum: a case report and review of the literature

A fibrous polyp of the verumontanum in a 10-year-old boy is described. The diagnosis, treatment and histology are discussed and the literature is reviewed. Perhaps this lesion will be noted more frequently with the availability of improved radiographic and cystoscopic techniques. The treatment has been greatly simplified with the advent of the pediatric resectoscope.

Submucosal fibromatosis: prostatism in a young boy?

A seven-year-old boy was seen with a urodynamically significant, obstructing, posterior urethral mass. It was believed to represent either a fibromuscular prostatic enlargement or a nonpedunculated congenital polyp. The differential diagnosis is discussed. Transurethral resection of the mass resulted in decreased voiding pressure and relief of symptoms.

Benign urethral polyp of prostatic urethra

Benign fibroepithelial polyps of the posterior urethra are rare lesions, usually presenting with obstructive symptoms. Most often they occur in the pediatric age group and are believed to be of congenital origin. Our patient, a fifty-nine-year-old man, represents the oldest case reported in the English literature. Current thoughts on diagnosis, associated urologic findings, treatment and possible cause are discussed.