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[Congenital urethral polyps. A rare cause of obstructive uropathy in childhood]
J Schäfer1, L Porkolab, A Pinter
1Chirurgische Abteilung Universitäts-Kinderklinik, Pécs.
Insights
Congenital urethral polyps are rare causes of urinary obstruction in children. Surgical removal of these polyps leads to significant symptom improvement and a good prognosis.
Area of Science:
- Pediatric Urology
- Urethral Abnormalities
Background:
- Congenital urethral polyps are exceedingly rare causes of obstructive uropathy in pediatric patients.
- These polyps typically originate from the seminal colliculus or prostatic urethral floor, presenting as pedunculated masses.
Observation:
- Three pediatric cases of severe infravesical obstruction caused by congenital posterior urethral polyps are presented.
- The polyps were histologically characterized by connective tissue, epithelium, smooth muscle, glandular cells, and nerve tissue.
Findings:
- Surgical intervention, including open cystotomy and transurethral excision, was performed in the presented cases.
- Post-polypectomy follow-up revealed normalized micturition behavior and marked improvement or complete resolution of urinary obstruction symptoms.
Implications:
- Congenital urethral polyps, though rare, are a treatable cause of severe pediatric urinary obstruction.
- Polypectomy offers a favorable prognosis, leading to functional recovery and stabilization of upper urinary tract status.
Abstract:
Congenital urethral polyps are an extremely rare cause of obstructive uropathy in childhood. Obstructing polyps arise on the seminal colliculus or the floor of the prostatic urethra. They are pedunculated, and the stalk can be several centimetres in length. Primarily they are composed of connective tissue covered by epithelium. Additionally, smooth muscles and islands of glandular cells and even nerve tissue have been found. We present three cases of children with congenital posterior urethral polyps causing severe infravesical obstruction. In two cases the polyps were excised at open cystotomy and in one case, transurethrally. The follow-up investigations confirmed a good prognosis of these patients: micturition behaviour had normalized and the symptoms of urinary obstruction had either markedly improved or completely disappeared. Dilatation of the upper urinary tract and loss of function resulting from recurrent urinary tract infection remained stable after relief of the obstruction by polypectomy.