Fibroepithelial Polyp of the Ureter: Its Presentation, Diagnosis and Treatment Modality

Abstract

Fibroepithelial polyp is the most common mesodermal tumor in the ureter, although its incidence is low. A total of only 23 cases, including 6 cases in this hospital, have been reported from the English literature after 1981, with the development of ureteroscopic techniques, for comparison with previous reports on presentation, diagnosis, and treatment modalities . The poylp was usually single (65%), and more commonly seen in males with a ratio of 1.3 to 1; usually it was seen in the upper third of the ureter (74%), in the left ureter (65%), and in the second to third decade of age. The symptoms were most commonly recurring loin pain (83%) and hematuria (48%). Usually intravenous urography could demonstrate an intraluminal, thin mass with smooth borders arising from a long stalk (mean 5.1 cm in length) and contrast medium could be seen passing alongside the polyp. Some degree of hydronephrosis and hydroureter might be seen (56%). The incidence of associated urinary.stone was 17.4%. With the introduction of ureteroscopy, preoperative diagnosis of the benign tumor has dropped the nephroureterectomy rate from 49% to 22%. Although segmental resection with reanastomosis is still the mainstay treatment method, long polyps located in the distal part of the ureter can be easily removed using a ureteroscope, without any complication or recurrence. In conclusion, it is important for the surgeon to be aware of the disease and its benign nature in order to have an accurate preoperative diagnosis, followed by renal-sparing surgery.