原发输尿管纤维上皮性息肉诊治分析(附七例报告)

Primary fibroepithelial polyp of ureter (report of 7 cases)

目的 总结原发输尿管纤维上皮性息肉的诊治经验。 方法 回顾分析 7例经病理证实为输尿管纤维上皮性息肉的患者临床资料。年龄 18～ 5 6岁 ,右侧 5例 ,左侧 2例。息肉位于输尿管上段 2例 ,中段 3例 ,下段 2例。临床表现多样 ,以血尿、侧腹痛为最常见症状 ,仅术前影像学检查难以确诊。 结果 7例患者手术治疗 5例 ,行钬激光切除术 2例。 7例术后随访 3个月～ 11年未见复发。 结论 肾盂输尿管造影有助于输尿管纤维上皮性息肉的诊断 ,必要时可行手术探查。输尿管镜是诊治此病的有效方法。

Objective To highlight diagnosis and treatment of primary fibroepithelial polyp of ureter. Methods 7 cases of primary fibroepithelial polyp of ureter treated from May of 1990 to July of 2002 were analyzed retrospectively.Among them ,18～56 age of year,and right side in 5 cases,left in 2 cases.The foci are in upper,middle and lower part 2,3,2 cases respectively.The diagnosis was all ascertained on pathological studies. Results Hematuria and flank pain are the usual presentation.Preoperative image will reveal the lesion but the diagnosis of fibroepithelial polyp cannot be made by radiographic means alone.Surgical intervention was undertaken in all 7 cases.The initial case has undergone unnecessary nephroureterectomy as misdiagnosis of carcinoma of ureter.Surgical exploration and polypectomy was performed in 4 cases and polypectomy with holimlaser under ureteroscopy in 2 cases.The therapeutic results were satisfactory without relapse in 3 months～11 years follow up. Conclusions The diagnosis may be established with intravenous urogram and retrograde pyelography and surgical exploration may be performed when necessary.With the advent of ureteroscopy, a new minimally invasive approach to fibroepithelial polyp of ureter was introduced.