Treatment and outcome of fibroepithelial ureteral polyps: A systematic literature review

• Published in: Canadian Urological Association journal Vol. 9; no. 9-10; pp. E631 - E637
• Main Authors: Ludwig, Dina J, Buddingh, Karel T, Kums, Jan J M, Kropman, René F, Roshani, Hossain, Hirdes, Willem H
• Format: Journal Article
• Language: English
• Published: Canada Canadian Urological Association 01.09.2015; Canadian Medical Association
• Subjects: Care and treatment; Diseases; Patient outcomes; Polyps (Pathology); Review; Ureters; United States
• ISSN: 1911-6470; 1920-1214
• DOI: 10.5489/cuaj.2878

Fibroepithelial polyps of the ureter are rare. Cases and small series are reported in the literature. The treatment of choice, outcome and appropriate follow-up regimen remain unclear. We conducted a systematic literature review of papers reporting fibroepithelial polyps of the ureter in adult patients. Articles published before 1980 were excluded. The search yielded 144 papers, of which 68 met the inclusion criteria. A reference scan from the included 68 yielded an additional 7 new articles. In total, our study included 75 articles (68 + 7). A total of 134 patients were described. Most patients had a single lesion (range: 1-10). The median length of the polyp was 4.0 cm (range: 0.4-17.0). The percentage of polyps resected endoscopically increased from 0% before 1985 to 67% after 2005. Two perioperative complications were reported in 72 procedures (2.8%): a deep venous thrombosis and a case of mesenteric lymphadenopathy. Both of these occurred after open surgery. Follow-up data were available for 57 patients. The median follow-up was 12 months (range: 1-180). Four patients (7.0%) developed recurrent complaints: 2 had urinary stones, 1 had a ureteral stricture and 1 had recurrence of the polyp. Three of these events followed endoscopic resection, and occurred within a year after the procedure. Endoscopic resection of fibroepithelial polyps seems to be safe and effective. It is minimally invasive and should be considered the gold standard where endoscopic expertise is available. We advise follow-up imaging by computed tomographic intravenous urography after 3 months and ultrasound after 1 year to detect late complications.