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Francesco Cattaneo. 1 Department of Surgery, Oncology, and Gastroenterology, Urology Clinic, University of Padua, Padua, Italy.
Fabio Zattoni. 1 Department of Surgery, Oncology, and Gastroenterology, Urology Clinic, University of Padua, Padua, Italy. 2 PhD Course in Clinical and Experimental Oncology and Immunology, Department of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy.
Luca Meggiato. 1 Department of Surgery, Oncology, and Gastroenterology, Urology Clinic, University of Padua, Padua, Italy.
Claudio Valotto. 1 Department of Surgery, Oncology, and Gastroenterology, Urology Clinic, University of Padua, Padua, Italy.
Fabrizio Dal Moro. 1 Department of Surgery, Oncology, and Gastroenterology, Urology Clinic, University of Padua, Padua, Italy.
Marina Paola Gardiman. 3 Department of Medicine, Surgical Pathology and Cytopathology Unit, University of Padova, Padova, Italy.
Paolo Beltrami. 1 Department of Surgery, Oncology, and Gastroenterology, Urology Clinic, University of Padua, Padua, Italy.
Filiberto Zattoni. 1 Department of Surgery, Oncology, and Gastroenterology, Urology Clinic, University of Padua, Padua, Italy.
Address correspondence to: Francesco Cattaneo, MD, Department of Surgery, Oncology, and Gastroenterology, Urology Clinic, University of Padua, Via Giustiniani 2, Padua 35100, Italy, E-mail: [email protected]
Introduction and Background
Ureteropelvic junction obstruction (UPJO) is defined as impaired urine flow from the pelvis into the proximal ureter because of congenital ureteral malformation or crossing vessels. Possible consequences of UPJO are the dilation of the collecting system and the risk of kidney failure. Indications for surgical correction are decreased renal function, stone development, urinary infections, or other clinical associated symptoms (e.g., abdominal pain, hematuria, dysuria, and flank discomfort). 1
Fibroepithelial polyps (FEPs) are a relatively rare cause of UPJO in the pediatric population, with an incidence reported of 0.5%. FEPs are more common in boys than in girls and they usually develop in the left side (up to 70%).2
FEPs are benign mucosal projections of fibrous stroma lined by surface epithelium. They may involve the renal pelvis, ureter, bladder, or urethra. Different phenotypes of FEPs have been described: some are long, cylindrical masses, whereas others are shorter, wider, and more likely to cause urinary obstruction. 1,2
Although the exact etiology of FEPs is unknown, chronic irritation or infections, developmental or allergic factors, trauma, or congenital causes could be implicated.
These entities may mimic the symptoms of intrinsic UPJO and are often undiagnosed until the...