Background: Ureteral fibroepithelial polyp is a rare benign lesion of the urinary tract. The incidence of the disease has been increasing recently; however, the aetiology of this tumour remains unclear. Early diagnosis and management are important, and endoscopic treatment is increasingly being preferred worldwide.Case Description: We report the case of a 49-year-old patient who presented with urinary frequency, intermittent haematuria, and an echogenic bladder mass found on pelvic sonography. Cystoscopy revealed an irregularly shaped large bladder mass, suggesting a benign or malignant bladder tumour. On subsequent examination, intravenous urography (IVU) and computed tomography showed a large lobulated contour filling defect in the bladder, measuring approximately 4 cm, with a suspected finding of a long stalk in the left distal ureter. Ureteroscopy revealed a long and narrow pedunculated tumour in the left distal ureter protruding into the bladder cavity through the ureteral orifice. On endoscopic excision, the attached stalk of the polyp into the ureter was cut using holmium:yttrium aluminium garnet (YAG) laser. The polyp was completely excised and extracted in its entirety, including the section protruding into the bladder.Histopathological findings confirmed the diagnosis of a fibroepithelial polyp. There was no sign of complication or recurrence on computed tomography performed after 12 months. Conclusions:The ureteral fibroepithelial polyp protruding into the bladder mimicked a bladder tumour and was successfully treated by endoscopic resection, with no complications or recurrence. Endoscopic treatment is an effective and safe method to treat fibroepithelial polyps of the ureter.
Background We aimed to evaluate the usefulness of the Beckman Coulter prostate health index (PHI) and to compare it with total prostate-specific antigen (PSA) levels and related derivatives in predicting the presence and aggressiveness of prostate cancer (PCa) in the Korean population. Methods A total of 140 men who underwent their first prostate biopsy for suspected PCa were included in this prospective observational study. The diagnostic performance of total PSA, free PSA, %free PSA, [–2] proPSA (p2PSA), %p2PSA, and PHI in detecting and predicting the aggressiveness of PCa was estimated using the receiver operating characteristic curve (ROC) and logistic multivariate regression analyses. Results Of 140 patients, PCa was detected in 63 (45%) of participants, and 48 (76.2%) of them had significant cancer with a Gleason score (GS) ≥ 7. In the whole group, the area under the curve (AUC) for ROC analysis of tPSA, free PSA, %fPSA, p2PSA, %p2PSA, and PHI were 0.63, 0.57, 0.69, 0.69, 0.72, and 0.76, respectively, and the AUC was significantly greater in the PHI group than in the tPSA group (p = 0.005). For PCa with GS ≥ 7, the AUCs for tPSA, free PSA, %fPSA, p2PSA, %p2PSA, and PHI were 0.62, 0.58, 0.41, 0.79, 0.86, and 0.87, respectively, and the AUC was significantly greater in the PHI group than in the tPSA group (p < 0.001). In the subgroup with tPSA 4–10 ng/mL, both %p2PSA and PHI were strong independent predictors for PCa (p = 0.007, p = 0.006) and significantly improved the predictive accuracy of a base multivariable model, including age, tPSA, fPSA and %fPSA, using multivariate logistic regression analysis. (p = 0.054, p = 0.048). Additionally, at a cutoff PHI value > 33.4, 22.9% (32/140) of biopsies could be avoided without missing any cases of aggressive cancer. Conclusions This study shows that %p2PSA and PHI are superior to total PSA and %fPSA in predicting the presence and aggressiveness (GS ≥ 7) of PCa among Korean men. Using PHI, a significant proportion of unnecessary biopsies can be avoided.
This study evaluates the relationship between menopausal hormone therapy (MHT) and the risk of urologic cancer in women. It was conducted for South Korea’s national population based on the National Health Insurance Service Database between January 2002 and January 2019. The types of MHT in this study included tibolone, combined oestrogen plus progestin by the manufacturer (CEPM) or physician (CEPP), and oral and topical oestrogen. Furthermore, select patient characteristics and reproductive factors were reviewed. We performed a Cox proportional hazard analysis to clarify the risk of urologic cancer associated with MHT. According to MHT types, 104,089 were treated with tibolone, 65,597 with CEPM, 29,357 with oral oestrogen, 3,913 with CEPP, and 1,174 with topical oestrogen. Among women on MHT, the incidence of kidney cancer was significantly increased with oral oestrogen (hazard ratio [HR] 1.36, 95% confidence interval [CI]: 1.062–1.735) and topical oestrogen (HR 2.84, 95% CI: 1.270–6.344), whereas other formulations were not associated with kidney cancer. Meanwhile, tibolone significantly decreased the incidence of bladder cancer (HR 0.69, 95% CI: 0.548–0.858), whereas other formulations were not associated with bladder cancer. Our findings suggest that MHT in postmenopausal women affects the incidence of urologic cancers.
Background: This study aimed to investigate the bladder cancer risk across workers' industries. Methods: This study was conducted using Korean National Health Insurance claims data. Workers were included in this study to build a retrospective cohort of the entire working population. Workers' industries were divided into 77 industries according to the Korean Standard Industry Classification division category. The standardized incidence ratio was calculated by comparing 77 industries according to the Korean Standard Industry Classification with the educational public officer. Results: Bladder cancer risk was particularly high in the following industrial sectors: passenger land transport, except transport via railways; sea and coastal water transport; restaurants and mobile food service activities; telecommunications; and computer programming, consultancy, and related activities. Conclusions: Our result provides evidence regarding the disparity of bladder cancer incidence among male workers across industries.
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