Treatment of large fibroepithelial polyps in the proximal ureter with antegrade plus retrograde endoscopic laser polypectomy.

The diagnosis and treatment of large fibroepithelial polyps in the proximal ureter have been the clinical challenges. This study retrospectively summarized the clinical diagnosis and treatment of fibroepithelial polyps >5cm in length in the proximal ureter of 6 patients who received treatment in the Affiliated Renji Hospital of Shanghai Jiaotong University School of Medicine between December 2010 and February 2017. The length of fibroepithelial polyps ranged from 5.8 to 8.2cm. There were 4 males and 2 females with the mean age of 32.6 +/- 9.8 years. Unilateral polyps were found in all patients (right: n=4; left: n=2). Hydronephrosis of different extents was noted in these patients, 4 complained of back pain and 2 were diagnosed with hydronephrosis by ultrasonography. 1 patient had macroscopic hematuria. All these patients received antegrade plus retrograde endoscopic laser polypectomy after admission. Symptoms were significantly improved after surgery, and ultrasonography showed hydronephrosis was attenuated to different extents 2 weeks later. Three months later, computed tomography urography revealed favorable recovery in 5 patients and deterioration of hydronephrosis due to ureteropelvic stenosis in 1 patient.