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Multiple metachronous fibroepithelial polyps in children.

Yoshiyuki Kojima1, Sarah M Lambert, Brian L Steixner

  • 1Division of Urology, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.

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|January 25, 2011
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Recurrent fibroepithelial polyps can occur in children after pyeloplasty. Routine imaging after surgery is recommended to detect and manage these urinary tract neoplasms effectively.

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Area of Science:

  • Pediatric Urology
  • Surgical Oncology
  • Nephrology

Background:

  • Fibroepithelial polyps (FEPs) are rare benign tumors causing ureteropelvic junction (UPJ) obstruction in children.
  • Robotic and laparoscopic pyeloplasty are standard treatments for UPJ obstruction.

Purpose of the Study:

  • To describe a new phenotype of recurrent FEPs in the urinary tract after minimally invasive pyeloplasty.
  • To discuss optimal management strategies for multiple metachronous FEPs in pediatric patients.

Main Methods:

  • Retrospective review of 14 children with FEPs undergoing pyeloplasty (robotic or laparoscopic).
  • Concomitant ureteroscopy was performed in 12 patients due to additional ureteral polyps.
  • Follow-up included retrograde pyelography and ureteroscopy at stent removal.

Main Results:

  • Recurrent FEPs were observed in 6 of 9 patients with at least 1-year follow-up.
  • Two patients experienced a second recurrence requiring laser ablation; one had a third recurrence.
  • No major intraoperative or postoperative complications were reported.

Conclusions:

  • Recurrence of FEPs should be considered in children with UPJ obstruction post-pyeloplasty.
  • Routine retrograde pyelography and ureteroscopy at stent removal are recommended.
  • Ureteroscopic management is suggested for multiple metachronous FEPs, pending further research.