Thulium Laser in The Management of Ureteral Fibroepithelial Polyps: A Multicenter Retrospective Study

Purpose: To retrospectively review the multicenter outcome of patients with ureteral fibroepithelial polyps (UFPs) after endoscopic management with thulium laser. Materials and Methods: A total of 21 adult patients with UFPs were treated in three medical centers between May 2007 and June 2018. We performed ureteroscopy operation and resected the polyps with thulium laser. The Double-J stent was removed 6 weeks after surgery during the 11-year follow-up period. Thereafter, we conducted computed tomography urography (CTU) or ultrasonic checks every 3-6 months. Results: All patients had UFPs resected with thulium laser. The mean length of the UFPs was 3.4 ± 1.43 cm (range 1.8-6.9). They included 12 men and 9 women with a mean age of 41.91 ± 13.56 years. Unilateral polyps were observed in 20 patients (left: n = 13; right: n = 7), whereas 1 patient had bilateral polyps. Back pain was the main symptom (12, 57.14%) identified. The amount of bleeding and the mean surgery time was 8.43 ± 4.02 mL and 42.43 ± 13.53 minutes, respectively. The average length of stay was 4 days (a range of 3-6 days). Notably, no patient exhibited ureteral perforation. We did not observe an increase in hydronephrosis during the follow-up period, ultrasonography showed that it was attenuated 6 weeks later. Besides, 3 months later, CTU revealed favorable recovery without recurrence or ureterostenosis. Conclusions: Ureteroscopy operation combined with thulium laser resection is a minimally invasive and effective method for treating UFPs. Based on our limited multicenter research findings, thulium laser achieves favorable outcomes in restoring drainage from the kidney and reduces recurrence.