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Published on: May 12, 2019
[Inverted urothelial papilloma: report of 151 cases]
Qun Wan1, Jin-dan Luo, Song-liang Cai
1Department of Urology, First Affiliated Hospital, Medical College of Zhejiang University, Hangzhou 310003, China. hz_wanqun@163.com
Objective:
To investigate the clinical features, pathology, diagnosis and treatment of inverted urothelial papilloma.
Methods:
A total of 151 cases of urothelial inverted papilloma were analysed retrospectively. Of the cases, 134 were male and 17 were female, with a mean age of 54 years old. Most patients complained of painless gross hematuria. The diagnosis could be established mainly by ultrasonic, intravenous urography, retrograde pyelography, cystoscope and pathology. Among them, 7 cases who had the papilloma at upper urinary tract underwent nephroureterectomy except one. One hundred and forty-four cases had the papilloma at low urinary tract, with 124 treated by transurethral bladder tumor resection (TURBT), among which 11 cases accompanying benign prostatic hyperplasia were treated by transurethral prostatic resection, 3 by transurethral resection of prostatic urethral tumor, 15 by partial cystectomy, 2 by total cystectomy.
Results:
One hundred and eighteen cases were followed up 1 year to 12.5 years (mean 6.3 years). Intravesical recurrence was found in 5 cases. Of them 2 cases developed malignance in 8 and 30 months postoperatively, and 1 case underwent total cystectomy.
Conclusions:
Inverted urothelial papilloma is a benign tumor, which appears male predominant. Most of the lesions are found in the bladder. TURBT is the preferred treatment choice for inverted papilloma of the bladder. Although this disease has a good prognosis, regular follow-up observations are necessary.
Insights
Inverted urothelial papilloma is a benign, male-predominant bladder tumor. Transurethral bladder tumor resection (TURBT) is the preferred treatment, with regular follow-up recommended due to potential recurrence.
Area of Science:
- Uro-oncology
- Pathology
- Surgical Oncology
Context:
- Inverted urothelial papilloma (IUP) is a rare benign neoplasm of the urinary tract.
- It predominantly affects males and is most commonly found in the bladder.
Purpose:
- To investigate the clinical features, pathology, diagnosis, and treatment of inverted urothelial papilloma.
- To evaluate treatment outcomes and recurrence rates.
Summary:
- A retrospective analysis of 151 IUP cases revealed a male predominance (134 males, 17 females) with a mean age of 54.
- Painless gross hematuria was the most common symptom. Diagnosis involved imaging (ultrasound, urography, pyelography) and pathology.
- Treatment varied by location: nephroureterectomy for upper tract tumors and transurethral bladder tumor resection (TURBT) for bladder tumors.
- Follow-up of 118 patients showed a 5-case recurrence rate, with 2 developing malignancy within 30 months.
Impact:
- TURBT is confirmed as the preferred treatment for bladder IUP.
- Despite a generally good prognosis, the study highlights the necessity of regular follow-up due to the risk of recurrence and malignant transformation.
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