Urethral polyp verumontanum in a 16-year-old boy - a rare condition

Abstract

Urethral polyps are a rare congenital condition, usually benign, localized on the posterior urethra, frequently developed from the verumontanum, with a large clinical impact in children. Typically, these are fibroepithelial structures with an unclear aetiology and unknown incidence. The clinical symptoms are difficult to early identify in the incipient stage and associates: urinary retention or voiding difficulties, urgency or hematuria. Urinary tract infections can be observed. We present a case of a 16 years old patient with lower urinary tract symptoms and incomplete urinary retention. He was suspicioned, based on the ultrasound evaluation, of a urinary bladder tumor (Fig.1-2). Physical examination and laboratory profile revealed a young teenager with a normal condition according to his age. The urethrocystoscopy exploration revealed a normal urethra with a protrusive intravesical polyp about 2 cm developed from the verumontanum. Transurethral resection of the tumor was performed under general anaesthesia with complete removal of the tumor and preserved anatomical structures at this level. The second day the urethral catheter was removed with a complete resumption of micturition. The pathology examination revealed a urethral polyp with fibroepithelial structure. No evidence of malignancy was found. Congenital urethral polyps are uncommon pathology that affects mostly young male teenagers. Differential diagnosis should be made with posterior urethral valve, florid cystitis cystica and cystitis glandularis, urothelial papilloma, inverted papilloma and rhabdomyosarcoma of the bladder [1]. The usual treatment consists in endoscopic approach with laser, electrocautery or cold resection.