1. When posterior urethral valves are not the answer,
look further : Posterior urethral polyps !
Preka E1, Poupalou A2, Ferreiro C2, Mergan F2, Van Vaerenbergh K2, Toppet V2, Steeman A2, Levy J2, Steyaert H1
1Hôpital Universitaire Des Enfants Reine Fabiola, Avenue Crocq 15, 1020 Bruxelles
2CHU Saint Pierre, Rue aux Laines 105, 1000 Bruxelles
1,2Universite libre de Bruxelles (ULB)
Background & Methods 1
Discussion 6
Posterior urethral polyp (PUP) is a rare congenital abnormality, more frequently encountered in males.
It should be given diagnostic consideration in patients presenting with symptoms of urinary outflow obstruction/retention, hematuria, and unusual urinary tract symptoms.
In few cases it presents as a protruding mass at the urethra meatus in females.
Methods : Retrospective review of 3 children with symptomatic genitourinary polyps
clinical suspicion :
Intermittent urinary retention
Persistent lower urinary tract symptoms (eg. Hematuria)
Recurrent epididymitis should also be considered !!
Management :
Gold standard: Urethrocystoscopy
with a double role :
diagnosis & treatment (incision)
Open cystotomy only when a transurethral resection is impossible.
Follow up: short due to absence of recurrence CONCLUSION: urethral polyp is to be considered in lower urinary tract symptomatology correlation between epididimytis and urethral polyp seems exceptional 2
Summary of Clinical Cases
Case 1
Case 2
Case 3
Clinical Presentation
6 months,
Antenatal unilateral pyelic dilatation 
Postnatal persistence of dilatation
11 months, antenatal bilateral hydronephrosis  postnatal persistence
suspicion of ureterocele
11 years, recurrent epidydimitis
Exams
Renal ultrasound
Voiding cystourethrogram
Cystoscopy 5
Results (γ)
Case 3
Recurrent epididymitis 
VCUG in order to rule out anatomic malformations: presence of a typical urethral polyp
Treatment of choice : Transurethral incision 4
Results (α)
Results (β) 3
Case 2
Case 1
VCUG: polyp (6,6mm) in the posterior urethra
no reflux associated
Right Kidney 73,7cm Left kidney 49,1cm
Cystoscopy: pedunculated polyp between
the bladder neck and the veru montanum
Histopathology: congenital fibroepithelial
polyp
References
VCUG: left grade III vesicoureteral reflux with ureteral diverticulum
intra-vesical polyp near the bladder neck, protruding in the urethra *
1) Aram Akbarzadeh, Reza Khorramirouz, Abdol-Mohammad Kajbafzadeh.
Congenital urethral polyps in children: Report of 18 patients and review of literature.
Journal of Pediatric Surgery 49 (2014) 835–839
2) Liu S. Xiaolong, Kreiger A. portia, Gould W. Sharon, Hagerty A. jennifer, Nemous/Alfred I. duPont
Congenital urethral polyps in the pediatric population. The Canadian journal of Urology (2013) Vol. 20, Issue 5,
3) R. De Castro, P. Campobasso, G. Belloli, P. Pavanello
Solitary Polyp of Posterior Urethra in Children: Report on Seventeen Cases. European Journal of Pediatric Surgery (1993) Apr;3(2): 92-6