You have accessJournal of UrologyCME1 Apr 2023V04-08 VIDEO ABSTRACT: NOVEL TREATMENT APPROACH OF A NEONATAL URETHRAL POLYP Kieran Moore, Rodrigo Romao, Daniel Keefe, and Dawn Maclellan Kieran MooreKieran Moore More articles by this author , Rodrigo RomaoRodrigo Romao More articles by this author , Daniel KeefeDaniel Keefe More articles by this author , and Dawn MaclellanDawn Maclellan More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003252.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urethral polyps are a rare entity, and typically present in male patients being investigated for dysuria, hematuria, or urinary retention. The etiology of these benign tumours remains unclear; however, they are likely to arise from the verumontanum (mesonephric duct), or a remnant from the sinus tubercule (paramesonephric duct). We describe a novel surgical approach to a urethral polyp causing urinary retention in a newborn. METHODS: A term baby (3815 g) admitted to the neonatal intensive care unit with congenital diaphragmatic hernia and respiratory distress was found to be in urinary retention post operatively. Comorbidities included pulmonary hypertension, bilateral hydroceles, and ear dysmorphism with normal microarray and spinal ultrasound (US). A formal US demonstrated an avascular mass in the urethra, suspicious for a polyp with a distended bladder and no hydronephrosis. Voiding cystourethrogram (VCUG) revealed a well-defined pedunculated polyp protruding into the urethra with voiding, and no evidence of reflux. Surgical options that have been described include resection with cold knife, fulguration and more recently, laser ablation. Additionally, larger polyps not amendable to endoscopic removal may require a trans-vesical approach. RESULTS: In the operating room, the ureteric orifices were orthotopic. The polyp was identified using a 6-French cystoscope just proximal of the verumontanum, with a well-defined stalk. Debris within the bladder suggested incomplete emptying. Given its large size and thin stalk, the polyp was resected in its entirety using a zero-tip loop-snare. Hemostasis was achieved with a monopolar fulgurating electrode. Pathology confirmed a benign urethral polyp. The baby was voiding well without urinary tract infections at follow up 6 weeks later, with no residual polyp or hydronephrosis on US. With this complete resection, prognosis remains excellent with recurrence unlikely. CONCLUSIONS: When suspected, the diagnosis of urethral polyps is achieved with VCUG and US, with ultimate endoscopic resection. We describe the successful endoscopic resection of a urethral polyp in a neonatal child with a loop snare, the first approach to our knowledge. This approach uses instruments readily available to the pediatric urologist and avoids the use of a resectoscope, and thus, the need for urethral dilatation in the newborn. Source of Funding: No funding © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e340 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kieran Moore More articles by this author Rodrigo Romao More articles by this author Daniel Keefe More articles by this author Dawn Maclellan More articles by this author Expand All Advertisement PDF downloadLoading ...