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Üriner sistemin dev fibroepitelyal poliplerinde tedavi değişkenlikleri: iki olgu sunumu

Treatment variabilities in the giant fibroepithelial polyps of the urinary system: presentation of two cases

Journal Name:

  • Gülhane Tıp Dergisi

Publication Year:

  • 2008

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Keywords (Original Language):

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Abstract (2. Language): 
We aimed to share our experience on the treatment variabilities of giant fibroepithelial polyps of the ureter in 2 patients in this article. Of the two patients first was a 53- year-old female patient with mild micturation problems. The polyp was a lesion protruted into the urinary bladder and detected incidentally. The second patient was a 36- year-old male patient with hematuria and right side pain. The polyp was found in the 1/3 distal portion of the ureter and caused ureterohydronephrosis. Both of the patients were performed endoscopic examination and biopsy. In the first patient transuretral resection was made with difficulty because of the hypermobility of the mass. But this difficulty was higher in the second patient because of the severe polypoid nature of the polyp. Surgical exploration was made, and excision of the 7×2 cm polyp and end to end anastomosis of the ureter were performed. The dilated distal segment of the ureter was excised, and insertion of a double-j stent was performed. Fibroepithelial polyps should always be kept in mind when a space-occupying mass is detected in the urinary system by visualization methods. The treatment model is variable but the endoscopic procedures should be the first step in the treatment approach.
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Abstract (Original Language): 
Bu yazıda üreterin dev fibroepitelyal poliplerinde tedavi değişkenlikleri ile ilgili 2 olgudaki tecrübemizi paylaşmayı amaçladık. İki hastanın birincisi 53 yaşında hafif miksiyon problemleri olan bir kadındı. Polip intravezikal olarak büyümüş tek bir lezyondu ve tesadüfen saptanmıştı. İkinci hasta ise hematüri ve sağ yan ağrısı olan 36 yaşında bir erkek hastaydı. Polip üreterin 1/3 distal kısmındaydı ve üreterohidronefroza yol açmıştı. Her 2 hastada endoskopik muayene ve biyopsi uygulandı. Birinci hastaya yapılan transüretral rezeksiyon işlemi kitlenin aşırı hareketliliğinden dolayı zor oldu. Fakat bu endoskopik rezeksiyon zorluğu ikinci hastada kitlenin ileri derecedeki polipoid yapısından dolayı çok daha fazlaydı. Hasta eksplore edilerek 7x2 cm'lik polip eksize edildi, üretere uç uca anastomoz yapıldı. Distal dilate üreter segmenti eksize edildi ve double-j stent kondu. Görüntüleme metodlarıyla üriner sistemde yer kaplayan bir kitle saptandığında fibroepitelyal polipler mutlaka akılda tutulmalıdır. Tedavi modelleri değişkendir fakat endoskopik yaklaşımlar mutlaka tedavinin birinci basamağını oluşturmalıdır.
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  • 2
137-140
  • Turkish

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