Abstract
IntroductionFibroepithelial polyps of the ureter are benign tumors arising from the mesodermal tissue in the ureteral wall. Their etiology remains unknown. Hematuria and obstructive urinary symptoms are the most common findings. The treatment of choice is endoscopic resection, and the prognosis for patients with these lesions is excellent.Case presentationWe present three cases of fibroepithelial polyps associated with calculi in the distal part of the ureter. The patients were all women, aged 20, 45 and 52 years. Two patients were suffering from flank pain and dysuria while one patient was asymptomatic at the time of diagnosis. The patients were fully treated with endoscopic resection. To the best of our knowledge, this is the fourth report of adult ureteral fibroepithelial polyps associated with ureteral calculi in the English literature. The etiology, clinical features, diagnosis, and management of fibroepithelial polyps are discussed in this report.ConclusionWhenever polypoid lesions are detected especially at the distal part of the ureter, benign fibroepithelial polyps should be kept in mind for differential diagnosis. Additionally, although rarely seen, the co-existence of ureteral calculi with fibroepithelial polyps should be borne in mind.
Highlights
Fibroepithelial polyps of the ureter are benign tumors arising from the mesodermal tissue in the ureteral wall
Rarely seen, the co-existence of ureteral calculi with fibroepithelial polyps should be borne in mind
We review our experiences with three patients having Fibroepithelial polyp (FEP) associated with calculi in the distal ureter to define this entity more clearly and its outcome following treatment
Summary
Ureteral FEP was first reported in 1932 [2], and since there have been approximately 236 scientific papers on fibroepithelial polyps. Fibroepithelial polyps of the lower urinary tract usually occur in the posterior urethra, most often in children They usually appear as solitary polyps; rare cases of multiple and bilateral appearances have been reported [3,5]. Fibroepithelial polyps were solitary in children, in the cases presented here they were multiple, located in the distal part of the ureter and associated with an adjacent ureteral calculus; this scenario has rarely been reported in the literature. In the cases presented here, urinary retention and chronic irritation due to the obstruction formed by the ureteral stones might have been responsible for the ureteral polyps, but the accepted theory in the literature is stone formation due to urinary retention caused by FEP In both situations, endoscopic management of FEP and calculi is safe, effective, and minimally invasive.
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