Service de chirurgie pédiatrique, Hôpital Mère-Enfant, Centre Hospitalier Universitaire de Limoges, 8 Avenue Dominique Larrey 87042, Limoges, France.
Service de chirurgie et urologie pédiatrique, Hôpital Universitaire Robert-Debré, APHP - Centre de Référence Maladies Rares « MARVU », Université de Paris, Paris, France; Pediatric Urology, Riley Children's Hospital, Indiana University School of Medicine, Indianapolis, IN, United States.
J Pediatr Surg. 2021 Feb;56(2):332-336. doi: 10.1016/j.jpedsurg.2020.05.030. Epub 2020 Jun 10.
Fibroepithelial polyps (FEP) of the lower urinary tract are relatively common in adults but rare in children, with fewer than 250 cases reported in the literature to date.
The aim of this study was to address the experience of FEP management in children.
A retrospective multicenter review was undertaken in children with defined FEP of the lower urinary tract managed between 2008 and 2018. The data at 18 pediatric surgery centers were collected. Their demographic, radiological, surgical, and pathological information were reviewed.
A total of 33 children (26 boys; 7 girls) were treated for FEP of the lower urinary tract at 13 centers. The most common presentation was urinary outflow as hematuria (41%), acute urinary retention (25%), dysuria (19%), or urinary infections (28%). A prenatal diagnosis was made for three patients with hydronephrosis. Almost all of the children (94%) underwent ultrasound imaging of the urinary tract as the first diagnostic examination, 23 (70%) of them also either had an MRI (15%), cystourethrography (25%), computerized tomography (6%), or cystoscopy (45%). Two of these children (6%) had a biopsy prior to the surgery. The median preoperative delay was 7.52 (range: 1-48) months. Most of the patients were treated endoscopically, although four (12.1%) had open surgery and two (6.1%) had an additional incision for specimen extraction. The median hospital stay was 1.5 (range: 1-10) days. There were no recurrences and no complications after a median follow-up of 13 (range: 1-34) months.
The main limitation of our study is the retrospective design, although it is the largest one for this pathology.
This series supports sonography as the most suitable diagnosis tool before endoscopy to confirm the diagnosis and to perform the resection for most FEP in children. This report confirms the recognized benign nature in the absence of recurrences.
Level V.
下尿路纤维上皮息肉（FEP）在成人中较为常见，但在儿童中罕见，文献中迄今为止报道的病例少于 250 例。
本研究旨在探讨儿童 FEP 的治疗经验。
对 2008 年至 2018 年间在 18 家小儿外科中心接受治疗的下尿路纤维上皮息肉患儿进行回顾性多中心研究。收集了他们的人口统计学、影像学、手术和病理信息。
共有 33 名儿童（26 名男孩；7 名女孩）在 13 家中心接受下尿路纤维上皮息肉治疗。最常见的表现是血尿（41%）、急性尿潴留（25%）、尿痛（19%）或尿路感染（28%）。3 名患有肾积水的患儿产前诊断为 FEP。几乎所有患儿（94%）均接受了尿路超声检查作为首次诊断检查，23 名患儿（70%）还接受了 MRI（15%）、膀胱尿道造影术（25%）、计算机断层扫描（6%）或膀胱镜检查（45%）。其中 2 名患儿（6%）在手术前进行了活检。术前平均等待时间为 7.52 个月（范围：1-48 个月）。大多数患儿采用内镜治疗，但有 4 名患儿（12.1%）接受了开放手术，2 名患儿（6.1%）因标本取出需要额外切口。平均住院时间为 1.5 天（范围：1-10 天）。中位随访 13 个月（范围：1-34 个月）后，无复发且无并发症。
本研究的主要局限性是回顾性设计，但这是该病理的最大系列研究。
本系列研究支持超声检查作为内镜前最适合的诊断工具，可确认诊断并对大多数儿童 FEP 进行切除。本报告证实了在无复发的情况下 FEP 的公认良性性质。
5 级。
