Atwa Ahmed M, Abdelhalim Ahmed, Edwan Mohamed, Soltan Mohamed, Hashim Abdelwahab, Abdelhameed Mohamed, Helmy Tamer, Hafez Ashraf, Dawaba Mohamed
Urology Department, Mansoura Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
Pathology Department, Mansoura Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
J Endourol Case Rep. 2020 Dec 29;6(4):457-460. doi: 10.1089/cren.2020.0099. eCollection 2020.
Urethral fibroepithelial polyps (FEPs) are scarce benign mesodermal tumors arising mainly from the posterior urethra in boys. FEPs are rarely reported in girls. There is no consensus regarding their etiology; however, some authors attribute their presence to abnormal mesodermal involution. FEPs have different clinical presentations, including acute urinary retention (AUR), difficult micturition, hematuria, and recurrent urinary tract infection in addition to interlabial mass in girls. Radiologic studies are usually insufficient for diagnosis. Cystourethroscopy and histopathologic examination are considered the diagnostic tool of choice. In this report, we introduce Holmium Laser En Bloc Resection of Urethral Polyp (HoLERUP) as an alternative technique to conventional and en bloc electric resection. Three boys with benign urethral polyps (UPs) presented with AUR, difficult micturition, and hematuria. The diagnosis of UP was confirmed by means of cystourethroscopy. HoLERUP was carried out for all three of them and histopathologic examination revealed FEP in two cases and an inflammatory polyp in the third. UPs should be considered in the differential diagnosis of children presenting with AUR, difficult micturition, and hematuria. HoLERUP overcomes the limitations of conventional resection and can be performed when en bloc electric resection is not feasible.
尿道纤维上皮息肉(FEPs)是一种罕见的良性中胚层肿瘤,主要发生于男孩的后尿道。女孩中FEPs的报道很少。关于其病因尚无共识;然而,一些作者认为其存在是由于中胚层异常退化所致。FEPs有不同的临床表现,包括急性尿潴留(AUR)、排尿困难、血尿、反复尿路感染,女孩还可出现阴唇间肿物。放射学检查通常不足以确诊。膀胱尿道镜检查和组织病理学检查被认为是首选的诊断方法。在本报告中,我们介绍了钬激光整块切除尿道息肉(HoLERUP)作为一种替代传统整块电切术的技术。三名患有良性尿道息肉(UPs)的男孩表现为急性尿潴留、排尿困难和血尿。通过膀胱尿道镜检查确诊为UP。对他们三人都实施了HoLERUP,组织病理学检查显示两例为FEP,第三例为炎性息肉。对于出现急性尿潴留、排尿困难和血尿的儿童,鉴别诊断时应考虑UPs。HoLERUP克服了传统切除术的局限性,在无法进行整块电切术时也可实施。