Mustafa GÜNEŞ, Muzaffer KELEŞ, Orahan KOCA, Ömer YILMAZ, Vecdet KAYA

Bilateral üreter obstrüksiyonunun nadir bir sebebi: Fibroepitelyal polip

Fibroepitelyal polipler, üriner sistemin nadir görülen, selim, epitelyal olmayan tümörleridir. Renal pelvis, üreter, mesane ve üretra tutulumu gösterebilirler. Mezoderm ve normal transizyonel epitel hücrelerinden bir araya gelmiş stromadan oluşurlar. Tümörlerin epitelyal kökenli olmalarının aksine, fibroepitelyal poliplerde maligniteye dönüşüm bildirilmemiştir. Fibroepitelyal polipler yeterince büyük ise, hematürinin eşlik ettiği ya da etmediği en yaygın başvuru semptomu olan tek taraflı böğür ağrısı ile üriner obstrüksiyona neden olabilirler. Kliniğimize bilateral böğür ağrısı ve makroskopik hematüri şikayeti ile başvuran 23 yaşındaki bir olguyu bildirdik.

An unusual cause of bılateral ureteral obstructıon: Fıbroepıthelıal polyp

Fibroepithelial polyps (FEP) of the urinary tract are rare, benign non-epithelial tumors. They may involve the renal pelvis, ureter, bladder or urethra. They are composed of stroma derived from mesoderm and covered by a layer of normal transitional epithelial cells. In contrast to tumors of epithelial origin, malignant degeneration of FEP has not been reported. FEP can cause urinary obstruction with the most common presenting symptom beign ipsilateral flank pain with or without hematuria. We report a 23 years-old woman who presented to our clinic with bilateral flank pain and macroscopic hematuria.

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1) Lam JS, Bingham JB, Gupta M. Endoscopic treatment of fibroepithelial polyps of the renal pelvis and ureter. Urology 2003;62(5):810-3.
2) Bhalla RS, Schulsinger DA, Wasnick RJ. Treatment of bilateral fibroepithelial polyps in a child. J Endourol. 2002;16(8):581-2.
3) Oguzkurt P, Oz S, Oguzkurt L, Kayaselcuk F, Tercan F. An unusual cause of complete distal ureteral obstruction: giant fibroepithelial polyp. J Pediatr Surg 2004;39(11):1733-4.
4) Williams TR, Wagner BJ, Corse WR, Vestevich JC. Fibroepithelial polyps of the urinary tract. Abdom Imaging 2002;27(2):217-21.
5) Carey RI, Bird VG. Endoscopic management of 10 separate fibroepithelial polyps arising in a single ureter. Urology 2006;67(2):413-5.
6) Kijvikai K, Maynes LJ, Herrell SD. Laparoscopic management of large ureteral fibroepithelial polyp. Urology 2007;70(2):373.e4-7.
7) Adey GS, Vargas SO, Retik AB, et al. Fibroepithelial polyps causing ureteropelvic junction obstruction in children. J Urol 2003;169(5):1834-6.
8) Romesburg JW, Stein RJ, Desai MM, Lagwinski N, Ross JH. Treatment of child with bilateral ureteropelvic junction obstruction due to fibroepithelial polyps and review of the literature. Urology 2009;73(4):929.e9-11.
9) Bartone FF, Johansson SL, Markin RJ, Imray TJ. Bilateral fibroepithelial polyps of ureter in a child. Urology 1990;35(6):519-2.