Endoscopic electroexcision of benign urethral tumors in children

Endoscopic treatment was performed in 17 boys aged 4 months - 16 years with benign newgrowths of the posterior urethra: false polyps (n = 11), fibroepithelial polyps (congenital - 4, acquired - 1), fetal rabdomyoma of the urethra and urinary bladder (n = 1). Acquired fibroepithelial polyp was detected in a patient who previously had resection and urethral anastomosis for posttraumatic stricture and long-term preventive catheterization. A leading symptom of the disease in 8 patients was infravesical obstruction. Most complete diagnostic information was provided by urethroscopy. All the patients were treated with endoscopic electroexcision of the tumors with coagulation of their bases. In a child with fetal rabdomyoma a vesicular part of the tumor was removed transvesically. Histological examination of the false polyps identified epithelium-covered granulation tissue. Fibroepithelial polyps were represented with mature connective tissue covered with urothelium. Recovery was achieved in all the patients. Benign urethral tumors should be considered in differential diagnosis in children as one of rare causes of infravesical obstruction. Most of the neoplasms are represented by congenital and acquired polyps of connective tissue of various maturity covered with transitory epithelium. False polyps may be an initial stage of the development of fibroepithelial acquired polyp. Factors of a higher risk of acquired urethral polyps are secondary trauma of urethral mucosa in device investigations and manipulations as well as chronic inflammation. A method of choice in the treatment of benign urethral neoplasms is endoscopic electroexcision which in some cases can be made with transvesicular approach.