Antegrade and retrograde laser excision and ureterotomy laser for ureteral polyp causing total ureteral stenosis following left ureteral stones removal: a case report and literature review

Abstract

Background: Ureteral polyps are rare, and the clinical manifestations are typically nonspecific. Obstruction from ureteral polyps can lead to ureteral stone formation. Excision using a less invasive approach is the most commonly performed procedure. Here, the authors report a patient with left proximal and distal ureteral polyps treated with laser excision after removal of the right kidney and left ureteral stone using a combined antegrade and retrograde route. This case is interesting because there was complete ureteral blockage, and polyps were found on the proximal and distal sides of the stenotic area. Case Presentation: A 55-year-old female patient came to our center with bilateral flank pain. Initially, the diagnosis was bilateral hydronephrosis, but after ureteroscopy (URS) was performed, proximal and distal ureteral polyps were identified. The polyp was excised using a Thulium laser, followed by DJ-stent placement. Discussion: Imaging with intravenous pyelography, CT, or retrograde urography can help diagnose ureteral polyps. Removal of the polyp’s base using ureteroscopy with laser coagulation allows for identification and histologic diagnosis. Endoscopic treatment has become the most commonly used treatment for ureteral polyps. Conclusion: Ureteral polyps are rare, and preoperative diagnosis may be difficult. Laser excision with stent placement after primary polyp removal has been reported in many studies to have good outcomes.