Is Endoscopic Management Suitable for Long Ureteral Fibroepithelial Polyps?

Fibroepithelial polyps of the ureter are rare benign tumors that have traditionally been managed by open exploration and resection. Endoscopic resection have been regarded as the gold standard for small lesions, while the management modality for long lesions is still controversial. We review our experience with ureteroscopic management of long (>6 cm) ureteral fibroepithelial polyps by holmium: yttrium-aluminum-garnet (YAG) laser resection. Five patients with a long ureteral fibroepithelial polyp underwent ureteroscopic resection using a holmium:YAG laser. Endoscopic management was successful in all five patients, and no major complications resulted from the approach. The average length of stay was 3 days (range 2-5 d). The mean length of the lesions were 11 cm (range 6-16 cm). The ureteral stent was removed at 6 weeks. No recurrences were seen during a mean followup of 24.2 months (range 3-51 mos). One ureteral stricture developed at 3 months, and the patient underwent endoscopic treatment by holmium:YAG laser. Endoscopic management of long ureteral fibroepithelial polyps is an acceptable modality with minimal morbidity and durable treatment results. The holmium:YAG laser offers the advantages of facilitating the use of a small-caliber fiber or flexible ureteroscope and allows safe destruction of the stalk and efficient removal of the entire polyp.