Preoperative diagnosis, treatment, and outcomes of FEPs of ureters in children: a 13-year retrospective study based on d
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ORIGINAL ARTICLE
Preoperative diagnosis, treatment, and outcomes of FEPs of ureters in children: a 13‑year retrospective study based on data at a large pediatric medical center Meng He1 · Ning Li1 · Weiping Zhang1 · Zhentao Ren1 Received: 24 February 2020 / Accepted: 20 July 2020 © The Author(s) 2020
Abstract Purpose To describe our experience in handling cases of children with fibroepithelial polyps (FEPs) of ureters. We specifically present preoperative diagnosis approaches, provide a clear definition of this entity and its outcomes following treatment. Method Clinical data of children with FEPs who were consecutively treated at Beijing Children’s Hospital from January 2006 to May 2019 were retrospectively analyzed in this study. The clinical data reviewed included diagnostic, intraoperative, and follow-up data. Results Of the 2653 children with surgery for hydronephrosis reviewed, 48 (1.8%) cases of FEPs of the ureters were identified, with a mean age of 109 ± 34.7 months. Among them, males accounted for 95.8%, left side for 81.3%, and proximal ureteral polyps for 97.9%. Notably, 70.8% of patients had only 1 polyp and the median size of the polyps was 2.1 ± 1.8 cm. All patients underwent ultrasound before surgery, which revealed the existence of polyps in 29 (60.4%) children. These polyps were completely resected surgically. The mean follow-up was 82 months (range of 6–153 months) and no cases of recurrences of polyps were seen after surgery during follow-up. The rate of other long-term complications was 9.3%. Conclusions In conclusion, FEPs are one of the important causes of hydronephrosis in children. Ultrasound is effective for preoperative diagnosis achieving higher true positive rates than other diagnostic methods. Although the recurrence rate of polyps and symptoms are low after complete resection in children, long-term follow-up is advocated to the adolescence stage to monitor the incidences of urinary tract infections, ureteropelvic junction obstruction and stone formation. Keywords Feps · Hydronephrosis · Polyps · Pediatric · Ureteral
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00345-020-03379-6) contains supplementary material, which is available to authorized users. * Ning Li [email protected] * Weiping Zhang [email protected] Meng He [email protected] Zhentao Ren [email protected] 1
Department of Urology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Nan Li Shi Lu Street No. 56, Beijing 100045, China
Fibroepithelial polyps (FEPs) of ureters are rare benign tumors in children. They have been linked to the occurrence of hydronephrosis. In a previous study, it was found that 0.5% of children with ureteropelvic junction obstruction developed this condition due to fibroepithelial polyps [1]. Histologically, FEPs are mesodermal tumors characterized by a loose vascular fibrous stroma with an overlying benign transitional epithelium [2]. Symptoms of FEPs include hematuria
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