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Genitourinary polyps in children
1Department of Urology, Mayo Clinic, Rochester, Minnesota.
Insights
Genitourinary polyps in children, though rare, present with hematuria or urinary obstruction. These benign growths are successfully treated with surgical excision, with no reported recurrences.
Area of Science:
- Pediatric Urology
- Genitourinary Pathology
Background:
- Genitourinary polyps are uncommon in pediatric patients.
- Understanding their presentation and management is crucial for timely diagnosis and treatment.
Purpose of the Study:
- To review the clinical presentation, diagnostic methods, treatment strategies, and long-term outcomes of genitourinary polyps in children.
- To analyze the natural history and recurrence rates of these pediatric genitourinary lesions.
Main Methods:
- Retrospective chart review of children under 16 with symptomatic genitourinary polyps (1957-1992).
- Analysis of patient demographics, polyp location, diagnostic imaging (excretory urography, voiding cystourethrography), endoscopic findings, and treatment modalities.
- Inclusion of literature review and long-term follow-up data.
Main Results:
- Common symptoms included hematuria (9 patients) and urinary tract obstruction (9 patients).
- Ureteral polyps (4 patients) were managed with ureterectomy or excision; urethral polyps (12 patients) were treated successfully with transurethral resection.
- Diagnostic tools like excretory urography and voiding cystourethrography were effective in identifying polyps.
Conclusions:
- Genitourinary polyps in children necessitate a high index of suspicion for diagnosis.
- Diagnostic modalities include excretory urography, voiding cystourethrography, and endoscopy.
- These polyps exhibit benign biologic activity with no recurrences after complete excision.
Objectives:
This study was undertaken to review the presenting complaints, diagnostic evaluation, treatment, and natural history of children with genitourinary polyps seen at the Mayo Clinic during the past 35 years.
Methods:
We retrospectively reviewed the charts of all children less than 16 years of age with symptomatic genitourinary polyps who were seen at the Mayo Clinic between 1957 and 1992. The age of each patient, clinical presentation, anatomic location of the polyp, diagnostic evaluation, and treatment were reviewed. Long-term follow-up data, including complications, were recorded, and the literature was reviewed.
Results:
The most common presenting symptoms were hematuria in 9 patients, (gross 7, microscopic 2) and urinary tract obstruction in 9 patients (upper tract 3, lower tract 6). Four children had ureteral polyps. Excretory urography showed hydronephrosis and filling defects in 3 patients and a filling defect without hydronephrosis in 1 child. Two patients underwent segmental ureterectomy, 1 had open excision of the polyp, and 1 had ureteroscopic excision. Urethral polyps were identified in 12 children, most often as a filling defect of the posterior urethra on voiding cystourethrography (5 patients) or during cystourethroscopy (7 patients). All 12 patients were managed successfully by transurethral resection.
Conclusions:
Genitourinary polyps in children require a high degree of alertness and can be diagnosed with excretory urography, with voiding cystourethrography, or endoscopically. The biologic activity of these polyps is uniformly benign, and there have been no recurrences following complete excision.