Cao Yang, Chen Qi, Zhong Hai, Xuan Han-Qing, Xia Lei, Xue Wei
Department of Urology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Medicine (Baltimore). 2018 Aug;97(32):e11747. doi: 10.1097/MD.0000000000011747.
The diagnosis and treatment of large fibroepithelial polyps in the proximal ureter have been the clinical challenges. This study retrospectively summarized the clinical diagnosis and treatment of fibroepithelial polyps >5 cm in length in the proximal ureter of 6 patients who received treatment in the Affiliated Renji Hospital of Shanghai Jiaotong University School of Medicine between December 2010 and February 2017. The length of fibroepithelial polyps ranged from 5.8 to 8.2 cm. There were 4 males and 2 females with the mean age of 32.6 ± 9.8 years. Unilateral polyps were found in all patients (right: n = 4; left: n = 2). Hydronephrosis of different extents was noted in these patients, 4 complained of back pain and 2 were diagnosed with hydronephrosis by ultrasonography. 1 patient had macroscopic hematuria. All these patients received antegrade plus retrograde endoscopic laser polypectomy after admission. Symptoms were significantly improved after surgery, and ultrasonography showed hydronephrosis was attenuated to different extents 2 weeks later. Three months later, computed tomography urography revealed favorable recovery in 5 patients and deterioration of hydronephrosis due to ureteropelvic stenosis in 1 patient.
近端输尿管大的纤维上皮性息肉的诊断和治疗一直是临床难题。本研究回顾性总结了2010年12月至2017年2月期间在上海交通大学医学院附属仁济医院接受治疗的6例近端输尿管纤维上皮性息肉长度>5 cm患者的临床诊断和治疗情况。纤维上皮性息肉长度为5.8至8.2 cm。男性4例,女性2例,平均年龄32.6±9.8岁。所有患者均为单侧息肉(右侧:n = 4;左侧:n = 2)。这些患者均有不同程度的肾积水,4例主诉腰痛,2例经超声检查诊断为肾积水。1例患者出现肉眼血尿。所有这些患者入院后均接受了顺行加逆行内镜激光息肉切除术。术后症状明显改善,2周后超声检查显示肾积水不同程度减轻。3个月后,计算机断层扫描尿路造影显示5例患者恢复良好,1例患者因输尿管肾盂狭窄导致肾积水恶化。