Abstract
Introduction:
Fibroepithelial polyps are rare benign tumors found in the ureters, bladder, or urethra that can cause obstruction or gross hematuria. We present a video of a robot-assisted laparoscopic approach in a 16-year-old male with a duplicated right collecting system found to have mid-ureteral polyps in the upper pole ureter causing painless gross hematuria.
Materials and Methods:
The patient underwent a CT urogram as part of his hematuria workup that showed mid-ureteral filling defects consistent with possible polyps. These were confirmed pathologically on diagnostic ureteroscopy and biopsy. Subsequently, he underwent a robot-assisted laparoscopic upper-to-lower ureteroureterostomy with excision of the upper pole ureteral segment containing the polyps.
Results:
The polyps extended from the upper mid-ureter up to almost the upper pole ureteropelvic junction. This segment was excised and the upper pole proximal ureter was anastomosed to the lower pole proximal ureter using 5-0 Monocryl. The lower pole ureter had been pre-stented with a Double-J before the anastomosis. The patient did well postoperatively, had his Foley removed on postoperative day 1, and was discharged to home on postoperative day 2. The stent was removed 5 weeks after the surgery. A subsequent renal ultrasound 4 weeks after stent removal showed no hydronephrosis, and the patient has remained symptom free.
Conclusions:
In a duplicated renal collecting system, we were effectively able to use the robotic platform to perform a segmental ureterectomy with upper-to-lower ureteroureterostomy for symptomatic fibroepithelial polyps.
No competing financial interests exist.
Runtime of video: 3 mins 49 secs
Keywords
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