Fukui Shinji, Yoshida Takashi, Nakao Kazuyoshi, Matsuzaki Tomoaki, Kinoshita Hidefumi
Department of Urology and Andrology Kansai Medical University Hirakata Osaka Japan.
IJU Case Rep. 2022 Mar 17;5(3):183-185. doi: 10.1002/iju5.12432. eCollection 2022 May.
Ureteral fibroepithelial polyps are extremely rare and cause ureteropelvic junction obstruction in the pediatric population. Recent advancements in endoscopic treatment, such as holmium:yttrium-aluminum-garnet laser, have created more options for practitioners to treat multiple ureteral fibroepithelial polyps cases. However, the use of holmium:yttrium-aluminum-garnet laser multilobulated ureteral fibroepithelial polyps may have technical difficulties.
An 11-year-old boy with intermittent right flank pain revealed multiple ureteral fibroepithelial polyps approximately 3 cm long at the right ureteropelvic junction. The ureteral fibroepithelial polyps were resected using flexible ureteroscopy using thulium:YAG laser. A second-look ureteroscopy revealed no recurrence, residual polyps, or ureteral stricture. At 1-year follow-up, ultrasonography showed no hydronephrosis on the affected side.
Thulium:YAG laser provides clear visibility due to its high hemostatic and evaporation effects. To the best of our knowledge, this is the first pediatric case of multiple ureteral fibroepithelial polyps successfully treated with endoscopic resection using thulium:YAG laser, with a favorable clinical outcome.
输尿管纤维上皮息肉极为罕见,可导致小儿人群输尿管肾盂连接处梗阻。内镜治疗的最新进展,如钬:钇铝石榴石激光,为从业者治疗多发性输尿管纤维上皮息肉病例创造了更多选择。然而,使用钬:钇铝石榴石激光治疗多叶状输尿管纤维上皮息肉可能存在技术困难。
一名11岁间歇性右腰腹痛男孩在右输尿管肾盂连接处发现多个约3厘米长的输尿管纤维上皮息肉。使用铥:钇铝石榴石激光通过软性输尿管镜切除输尿管纤维上皮息肉。二次输尿管镜检查未发现复发、残留息肉或输尿管狭窄。在1年的随访中,超声检查显示患侧无肾积水。
铥:钇铝石榴石激光因其高止血和蒸发效果而具有清晰的视野。据我们所知,这是首例使用铥:钇铝石榴石激光内镜切除成功治疗多发性输尿管纤维上皮息肉的儿科病例,临床效果良好。