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Treatment of Ejaculatory Duct Obstruction by Seminal Vesiculoscopy Assisted Flow Modification
Published on: December 8, 2023
[Endoscopic electroexcision of benign urethral tumors in children]
Insights
Endoscopic electroexcision effectively treats benign urethral tumors in children, including false and fibroepithelial polyps, resolving infravesical obstruction. This minimally invasive approach ensures complete recovery for pediatric patients.
Area of Science:
- Pediatric Urology
- Surgical Oncology
- Pathology
Context:
- Benign urethral neoplasms are rare in children, often presenting as infravesical obstruction.
- Diagnostic challenges exist, with urethroscopy providing the most comprehensive information.
- False polyps and fibroepithelial polyps are common types, with acquired forms linked to prior trauma and catheterization.
Purpose:
- To evaluate the efficacy of endoscopic treatment for benign urethral new growths in pediatric patients.
- To analyze the types, presentation, and histological characteristics of these tumors.
- To establish endoscopic electroexcision as the primary treatment modality.
Summary:
- Seventeen boys (4 months–16 years) with benign urethral tumors (false polyps, fibroepithelial polyps, fetal rhabdomyoma) underwent endoscopic treatment.
- Endoscopic electroexcision with coagulation was the primary method, with a transvesical approach for rhabdomyoma.
- Histology confirmed granulation tissue (false polyps) and connective tissue (fibroepithelial polyps). All patients achieved recovery.
Impact:
- Endoscopic electroexcision is a safe and effective treatment for pediatric benign urethral neoplasms.
- Highlights the importance of considering urethral tumors in the differential diagnosis of infravesical obstruction in children.
- Identifies risk factors for acquired polyps, including urethral trauma and chronic inflammation.
Abstract:
Endoscopic treatment was performed in 17 boys aged 4 months-16 years with benign new growths of the posterior urethra: false polyps (n = 11), fibroepithelial polyps (congenital--4, acquired--1), fetal rabdomyoma of the urethra and urinary bladder (n = 1). Acquired fibroepithelial polyp was detected in a patient who previously had resection and urethral anastomosis for posttraumatic stricture and long-term preventive catheterization. A leading symptom of the disease in 8 patients was infravesical obstruction. Most complete diagnostic information was provided by urethroscopy. All the patients were treated with endoscopic electroexcision of the tumors with coagulation of their bases. In a child with fetal rabdomyoma a vesicular part of the tumor was removed transvesically. Histological examination of the false polyps identified epithelium-covered granulation tissue. Fibroepithelial polyps were represented with mature connective tissue covered with urothelium. Recovery was achieved in all the patients. Benign urethral tumors should be considered in differential diagnosis in children as one of rare causes of infravesical obstruction. Most of the neoplasms are represented by congenital and acquired polyps of connective tissue of various maturity covered with transitory epithelium. False polyps may be an initial stage of the development of fibroepithelial acquired polyp. Factors of a higher risk of acquired urethral polyps are secondary trauma of urethral mucosa in device investigations and manipulations as well as chronic inflammation. A method of choice in the treatment of benign urethral neoplasms is endoscopic electroexcision which in some cases can be made with transvesicular approach.
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