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CONCLUSIONS
Robotic surgery is becoming increasingly popular also in the pediatric field. Our case shows how
simple enucleation can be achieved even in pediatric patients, despite the small size of the operat-
ing field requires a good experience for the correct positioning of the patient. To avoid internal/
external conflicts the Da Vinci robot Xi finds particular application in pediatric urology.
VS-11 (VS without presentation)
URETEROPELVIC FIBROEPITHELIAL POLYP MIMICKING
A STONE ON ULTRASOUND: URETERORENOSCOPY
AND LAPAROSCOPY FOR DIAGNOSIS AND MANAGEMENT
Baran TOKAR, Cigdem ARSLAN ALICI and Akin KARAGOZOGLU
Eskisehir Osmangazi University, Faculty of Medicine, Department of Pediatric Surgery, Section of Pediatric Urology,
Eskisehir, TURKEY
PURPOSE
Fibroepithelial polyp on ureteropelvic junction (UPJ) is a rare pathology that causes upper urinary
tract obstruction. Preoperative radiological examination may not demonstrate the exact pathology.
It might be determined in patients who have operation for UPJ obstruction.
MATERIAL AND METHODS
In this video, we present a 6 year old boy who was referred to our clinic with a suspicion of a diagnosis
of obstructive stone on UPJ. Ureterorenoscopy showed a polypoid lesion on UPJ and laparoscopy
was performed for resection and pyeloplasty.
RESULTS
The patient had a complaint of hematuria and left lumbar pain that was intensified in the last
couple of days. Ultrasound showed hydronephrosis and 6 mm stone like appearance on UPJ.
Ureterorenoscopy found a broad base Medusa head like polypoid lesion on UPJ with arms protrud-
ing into the pelvis and ureter. Following the lateral flank position of the patient, laparoscopic retro-
colic exploration of the left kidney was done. UPJ was exposed, ureteropelvic lumen was opened
with a vertical incision; the polyp was found and the segment of UPJ with the polyp was resected.
Pyeloplasty was performed with a JJ stent insertion. The patient did well at six-month follow-up.
CONCLUSIONS
Fibroepithelial polyp should be considered in differential diagnosis of UPJ obstruction. It may mimic
a stone on ultrasound. Endoscopic excision of polyp is possible, but a polyp that has a broad base
and atypical macroscopic appearance should be excised surgically as in our case. Laparoscopic
approach is a right preference for surgeons who have experience on laparoscopic pyeloplasty.