When posterior urethral valves are not the answer, look further : Posterior urethral polyps ! Preka E1, Poupalou A2, Ferreiro C2, Mergan F2, Van Vaerenbergh K2, Toppet V2, Steeman A2, Levy J2, Steyaert H1 1Hôpital Universitaire Des Enfants Reine Fabiola, Avenue Crocq 15, 1020 Bruxelles 2CHU Saint Pierre, Rue aux Laines 105, 1000 Bruxelles 1,2Universite libre de Bruxelles (ULB) Background & Methods 1 Discussion 6 Posterior urethral polyp (PUP) is a rare congenital abnormality, more frequently encountered in males. It should be given diagnostic consideration in patients presenting with symptoms of urinary outflow obstruction/retention, hematuria, and unusual urinary tract symptoms. In few cases it presents as a protruding mass at the urethra meatus in females. Methods : Retrospective review of 3 children with symptomatic genitourinary polyps clinical suspicion : Intermittent urinary retention Persistent lower urinary tract symptoms (eg. Hematuria) Recurrent epididymitis should also be considered !! Management : Gold standard: Urethrocystoscopy with a double role : diagnosis & treatment (incision) Open cystotomy only when a transurethral resection is impossible. Follow up: short due to absence of recurrence CONCLUSION: urethral polyp is to be considered in lower urinary tract symptomatology correlation between epididimytis and urethral polyp seems exceptional 2 Summary of Clinical Cases Case 1 Case 2 Case 3 Clinical Presentation 6 months, Antenatal unilateral pyelic dilatation  Postnatal persistence of dilatation 11 months, antenatal bilateral hydronephrosis  postnatal persistence suspicion of ureterocele 11 years, recurrent epidydimitis Exams Renal ultrasound Voiding cystourethrogram Cystoscopy 5 Results (γ) Case 3 Recurrent epididymitis  VCUG in order to rule out anatomic malformations: presence of a typical urethral polyp Treatment of choice : Transurethral incision 4 Results (α) Results (β) 3 Case 2 Case 1 VCUG: polyp (6,6mm) in the posterior urethra no reflux associated Right Kidney 73,7cm Left kidney 49,1cm Cystoscopy: pedunculated polyp between the bladder neck and the veru montanum Histopathology: congenital fibroepithelial polyp References VCUG: left grade III vesicoureteral reflux with ureteral diverticulum intra-vesical polyp near the bladder neck, protruding in the urethra * 1) Aram Akbarzadeh, Reza Khorramirouz, Abdol-Mohammad Kajbafzadeh. Congenital urethral polyps in children: Report of 18 patients and review of literature. Journal of Pediatric Surgery 49 (2014) 835–839 2) Liu S. Xiaolong, Kreiger A. portia, Gould W. Sharon, Hagerty A. jennifer, Nemous/Alfred I. duPont Congenital urethral polyps in the pediatric population. The Canadian journal of Urology (2013) Vol. 20, Issue 5, 6974-6977 3) R. De Castro, P. Campobasso, G. Belloli, P. Pavanello Solitary Polyp of Posterior Urethra in Children: Report on Seventeen Cases. European Journal of Pediatric Surgery (1993) Apr;3(2): 92-6