Abdullaev F K, Nikolaev V V, Kulaev V D, Nazhimov V P
Urologiia. 2009 Jan-Feb(1):63-6.
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.
对17名年龄在4个月至16岁之间、患有后尿道良性新生物的男孩进行了内镜治疗:假性息肉(n = 11)、纤维上皮性息肉(先天性——4例,后天性——1例)、尿道及膀胱胎儿横纹肌瘤(n = 1)。一名曾因创伤后狭窄行切除术及尿道吻合术并长期预防性留置导尿管的患者被发现患有后天性纤维上皮性息肉。8例患者的主要疾病症状为膀胱下梗阻。尿道镜检查提供了最完整的诊断信息。所有患者均接受了肿瘤内镜电切术,并对其基底部进行了凝固。对于一名患有胎儿横纹肌瘤的儿童,经膀胱切除了肿瘤的泡状部分。假性息肉的组织学检查发现为上皮覆盖的肉芽组织。纤维上皮性息肉表现为覆盖有尿路上皮的成熟结缔组织。所有患者均康复。在儿童的鉴别诊断中,应将良性尿道肿瘤视为膀胱下梗阻的罕见原因之一。大多数肿瘤表现为各种成熟度的先天性和后天性结缔组织息肉,覆盖有移行上皮。假性息肉可能是后天性纤维上皮性息肉发展的初始阶段。后天性尿道息肉的高风险因素包括器械检查和操作中尿道黏膜的继发性创伤以及慢性炎症。治疗良性尿道肿瘤的首选方法是内镜电切术,在某些情况下可采用经膀胱入路。