Fibrous polyp of the ureter

Treatment and outcome of fibroepithelial ureteral polyps: A systematic literature review

INTRODUCTION

Fibroepithelial polyps of the ureter are rare. Cases and small series are reported in the literature. The treatment of choice, outcome and appropriate follow-up regimen remain unclear.

METHODS

We conducted a systematic literature review of papers reporting fibroepithelial polyps of the ureter in adult patients. Articles published before 1980 were excluded.

RESULTS

The search yielded 144 papers, of which 68 met the inclusion criteria. A reference scan from the included 68 yielded an additional 7 new articles. In total, our study included 75 articles (68 + 7). A total of 134 patients were described. Most patients had a single lesion (range: 1-10). The median length of the polyp was 4.0 cm (range: 0.4-17.0). The percentage of polyps resected endoscopically increased from 0% before 1985 to 67% after 2005. Two perioperative complications were reported in 72 procedures (2.8%): a deep venous thrombosis and a case of mesenteric lymphadenopathy. Both of these occurred after open surgery. Follow-up data were available for 57 patients. The median follow-up was 12 months (range: 1-180). Four patients (7.0%) developed recurrent complaints: 2 had urinary stones, 1 had a ureteral stricture and 1 had recurrence of the polyp. Three of these events followed endoscopic resection, and occurred within a year after the procedure.

CONCLUSION

Endoscopic resection of fibroepithelial polyps seems to be safe and effective. It is minimally invasive and should be considered the gold standard where endoscopic expertise is available. We advise follow-up imaging by computed tomographic intravenous urography after 3 months and ultrasound after 1 year to detect late complications.

Fibroepithelial ureteral polyps and urolithiasis

Fibroepithelial polyps are the most common benign tumor of the ureter. Most of the literature regarding their cause ascribes it to chronic infection. These publications, however, show that the majority of such cases never were associated with a documented urinary tract infection. Fibroepithelial polyps appear with equal frequency in male and female subjects and are found in all age groups including children, in contrast to what would have been expected with an infectious cause. Four histologically confirmed cases of fibroepithelial polyps were associated with chronic inflammation of the upper urinary tract related to the presence of calculi and/or Double J ureteral stents. All patients were managed successfully by endoscopic means, preserving renal function. Fibroepithelial ureteral polyps may be associated with urolithiasis, which serves as a source of chronic inflammation. A review of the literature is presented and supports these observations.

Vascular polyps of ureter associated with megacalycosis and nephrolithiasis

Multiple benign vascular polyps of the ureter are rare, and the associated congenital megacalycosis and nephrolithiasis are very uncommon. Herein we report a case with vascular polyps of the right ureteropelvic junction dissociated with extensive hydronephrosis which was considered to be megacalycosis. Clinical features and treatment modalities are reviewed.

Giant fibrous polyp of a calyx

A case of a giant fibrous polyp of the pyelocaliceal system producing hydronephrosis is described. The presentation of the findings in this case as well as brief review of the literature are included.

Benign fibroepithelial polyps as a cause of intermittent ureteropelvic junction obstruction in a child: a case report and review of the literature

A 10-year-old boy had intermittent ureteropelvic junction obstruction that proved to be owing to benign fibroepithelial polyps. The clinical features and management of this rare lesion are discussed.