Robot-assisted right ureteral polypectomy: A case report

Abstract

Ureteral polyps are a rare cause of ureteral obstruction in the adult and pediatric populations. Fibroepitheial polyps (FEP) are the most common type of ureteral polyps. This clinical entity is very rare, warranting periodic clinical review by practitioners, and new advancements in laparoscopy allow new surgical approaches to its cure. We present the case of a 20-year-old male with right-sided flank pain. He was found to have right ureteropelvic junction (UPJ) obstruction and subsequently underwent laparoscopic robotic-assisted right collecting system exploration, excision of polyps and right ureteropyeloplasty. Ureteral polyps were excised and determined to be fibroepithelial in origin based on the pathological report. Our case highlights the importance of having FEP in the differential diagnosis of ureteral obstruction. We also found that laparoscopic robot-assisted polypectomy is a safe and acceptable surgical option for the excision of ureteral polyps.

Fig. 1.

A computed tomography of the abdomen/pelvis without contrast showing right hydronephrosis.

Fig. 2.

An intravenous pyelography with nephrotomography showing right-sided pelvicaliectasis with abrupt narrowing of the uteropelvic junction on the right with no obstructing mass seen.

Fig. 3.

A nuclear renal scan showing incomplete ureteropelvic junction stenosis of right collecting system.

Fig. 4.

A renogram reveals discrepant percent activity with 57% of the activity on the left and 49% on the right.