Utilizing ultrasonography in the diagnosis of pediatric fibroepithelial polyps causing ureteropelvic junction obstruction

Wang, Xiao Man; Li, Jia; Wang, Yu; Wang, Ning

doi:10.1007/s00247-012-2404-4

Cited by 17 publications

(8 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Duplex Doppler sonography revealed masses of mildly echogenic and non-shadowing with well-defined margins outlined by a urine-distended pelvis and blood flow. In addition, the renal pelvis appeared dilated while the ureter appeared nondilated [4]. We believe that the false-negative rate is due to limited experience, and an experienced pediatric ultrasound doctor can easily diagnose more than half of ureteral polyps.…”

Section: Discussionmentioning

confidence: 97%

“…To perform intravenous urography (IVU), abdominal plain films were performed at 10, 20, and 40 min following contrast injection. For all ultrasound studies, the children were fasted for 8 h, and then drank adequate amounts of water (about 500-1000 ml) for 30 min to cause diuresis and dilate the renal pelvis to enhance detection of obstruction and visualization of fibroepithelial polyps [4]. The diagnosis of FEPs was based on intraoperative direct vision findings and histology.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

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

Zhang

et al. 2020

World J Urol

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 97%

Section: Methodsmentioning

confidence: 99%

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

Zhang

et al. 2020

World J Urol

View full text Add to dashboard Cite

show abstract

“…It will show hydronephrosis secondary to the obstruction as well as a mildly echogenic non-acoustic shadowing with well-defined margins. Coupling ultrasonography with color Doppler could also show us blood flow in the polyp [4,5]. Wang et al report the accuracy of an ultrasound scan in detecting ureteral polyps at 62.6% [5].…”

Section: Discussionmentioning

confidence: 99%

Fibroepithelial Polyp in a Child: A Rare Pathology of Upper Urinary Tract Obstruction

Alhindi

Alaradi

Mubarak

2020

Cureus

View full text Add to dashboard Cite

Fibroepithelial polyp is a rare benign tumor of the urothelial system that originates from the mesoderm. Polyps are usually small and located in the upper urinary tract and ureteropelvic junction. However, in the pediatric population, such polyps are more common in the posterior urethra and will present with symptoms of urinary tract obstruction. Some will present with flank pain and hematuria, resembling symptoms of ureteric stones. In this case, we discuss a nine-year-old boy presenting with complaints of flank pain and hematuria for one year. Following laboratory and radiological investigations, the left ureter was dilated at the midlumbar region with an anteroposterior diameter of 2.3 x 0.6 cm and a left renal pelvis anteroposterior diameter of 2.2 cm. An ultrasound scan identified an intraluminal lesion suspected to be a fibroepithelial polyp. Management was carried out via retroperitoneal surgery with upper ureteral resection and end-to-end anastomosis. Postoperatively, the patient's symptoms improved, and a subsequent ultrasound scan and renal function test showed improvement of the left hydroureter and hydronephrosis.

show abstract

“…Ultrasonography of the kidney may show mild-to-moderate hydronephrosis when the patient is asymptomatic and well, while this finding is markedly aggravated in association with acute attack of pain and other symptoms 7. Colour Doppler helps in ruling out lower polar vessels as the cause of Dietl's crisis.…”

Section: Discussionmentioning

confidence: 99%

Antenatal mild hydronephrosis with subsequent polyp of the upper ureter in a child presenting with recurrent Dietl's crisis

et al. 2014

View full text Add to dashboard Cite

We report a 7-year-old boy who had antenatally diagnosed and postnatally confirmed asymptomatic right congenital hydronephrosis secondary to ureteropelvic junction obstruction with the anteroposterior diameter ranging from 7 to 15 mm on serial ultrasound scans till the age of 6 years. He then presented with recurrent attacks of Dietl's crisis almost every month in the seventh year of his life and eluded diagnosis for over a year at various national hospitals, and ended up with an international referral to us. Investigations of the acute attacks clinched the diagnosis of ureteral polyp causing intermittent crisis and he underwent segmental resection and reconstruction in the form of dismembered Anderson-Hyne pyeloplasty with good recovery. Our case revealed that prenatally detected hydronephrosis may worsen after spontaneous postnatal improvement and a polyp acting as a flip valve may produce intermittent hydronephrosis and symptoms later in life. The child should undergo urgent investigations during acute symptoms.

show abstract

Utilizing ultrasonography in the diagnosis of pediatric fibroepithelial polyps causing ureteropelvic junction obstruction

Abstract: US is an effective screening tool for identifying fibroepithelial polyps causing UPJ obstruction in children.

Cited by 17 publications

References 11 publications

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

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

Fibroepithelial Polyp in a Child: A Rare Pathology of Upper Urinary Tract Obstruction

Antenatal mild hydronephrosis with subsequent polyp of the upper ureter in a child presenting with recurrent Dietl's crisis

Contact Info

Product

Resources

About