Fibroepithelial polyps of the ureter: A single-institutional experience

Objective: Ureteral fibroepithelial polyps (UFP) are rare lesions that may mimic ureteral malignancy, and management is not well defined. We report our experience with the management of UFP. Materials and Methods: Between 1945 and 2008, review of our clinical database identified 27 patients who were found to have UFP. Single-pathologist review excluded five patients (three papilloma, one inflammatory pseudopolyp, and one nondiagnostic). Fisher's exact methods were utilized to assess significance of clinical associations. Results: Mean age at diagnosis was 40 years (range 7-73 years) and 68% were male. Mean follow-up was 37 months (range 2-276 months). History of urologic conditions occurred in 13 patients: 7 (32%) urolithiasis, 2 (9%) ureteral stents, 1 (5%) recurrent urinary tract infection, and 3 (14%) ureteropelvic junction obstruction. Mean UFP diameter was 2cm (range 0.5-4cm). UFP was more common in the left ureter (68%, 15/22). UFP location within the ureter was proximal in 13 (59%, 15/22), mid in 4 (18%, 4/22), and distal in 4 (18%, 4/22) with multiple UFP along the length of one ureter. Six patients (27%) had multiple UFP. Open surgery, last performed in 1994, was the initial treatment in 10 (45%, 10/22) patients. Endoscopic treatment was performed in 12 (55%, 12/22) patients and was successful in 11. After endoscopic treatment, open surgical treatment was required in 3 patients with ureteral stricture and 1 patient with incomplete polyp resection. UFP reoccurred in 1 patient (1/12) at 26 months and was successfully treated with ureteroscopy. Conclusions: We conclude that UFP can be successfully managed with endoscopic techniques. Postoperative surveillance is recommended for potential early detection of ureteral stricture or recurrence.