| Inverted papilloma(IP) of the urinary tract, which has the characteristics including inverted growth, predominance in man and common in bladder, is generally thought of a rare benign tumor. It was described by Paschkis in 1927 and then named by Potts and Hirst in 1963. The number of IP reported by clinicians was over 300 cases. Now because of its recurrence, multiple growth and low malignant potentiality in biology behavior, IP is emphasized by urologists day by day.Material and MethodsThis study included 113 patients, 102 were men and 11 were women. The mean age was 54.8 years (range, 20 to 78 years). 5 cases, which had the similar symptoms that included gross hematuria, lumbago and streak blood clotting in urine, were diagnosed occupancy in upper urinary tract and hydronephrosis with B-US, IVU and RGP. The history of them was 1 week to 1 year. 108 cases, which included 107 in bladder and 1 in urethra, were diagnosed occupancy in bladder and neoplasm in urethra with cystoscopy. Of them 80 cases had gross hematuria, 24 cases had urinary frequency, urodynia, urgency and difficulty of urination. Turthermore, 10 cases companied BPH and 4 were detected with BUS occasionally. The history of them was 1 week to 6 years.Of 5 cases with IP in the upper urinary tract, 1 was in right pelvis, 1 was in left pelvis, which were 1.0cm+1.5cm and 2.0cm+3.0cm respectively; 1 was multiplicity in left ureter, 1 was multiplicity in left pelvis and ureter, 1 was multiplicity in right pelvis and ureter, which were from 0.5 cm+0.5cm to 2.5cm+3.0cm; all patients were undergone the resection of pelvis and ureter.Of 108 cases with IP in the low urinary tract, 95 was in bladders, 51 in the neck, 30 in the triangular area, 4 in bottom, 3 in the left wall, 7 in right wall of the bladder. 87 were undergone TURBt, 6 were undergone TURP and TUPBt, 10were undergone partial-cystectomy, 4 were undergone partial-cystectomy and prostatectomy, 1 were undergone total-cystectomy and Bricker operation.ResultsAll patients recovered better without severe complications. The specimens from all patients were obtained and examined for pathologic study. 86 cases had been followed-up for 0.5-10 years(average 5.4 years). 1 case, which was undergone partial-cystectomy before 8 months ago, was found recurrent after examining by cystoscope and was performed by TURBt and biopsied together, it was diagnosised as cancer and was performed total-cystectomy and Bricker operation. Another case, which was undergone operation before 2.5 years ago, was found recurrent after examining by cystoscope, it was performed TURBt and diagnosised cancer. 3> cases, which were undergone operation before 2, 6, 8 years ago respectively, were found repeaed, all of them were performed partial-cystectomy and the diagnoses was IP too, they had no repea after following-up from 3 to 7 years. The rest of 81 cases had no repea yet.Conclusion1. Inverted papilloma(IP) of the urinary tract is a rare benign tumor . It appears a male predominance and common in bladder.2. Etiological factor is not clear. It is thought that chronic stimulation of inflammation would cause partial epithelia proliferation abnormally, and chemical substances are maybe the other factors.3. The clinical symptom is gross hematuria, and more common in the cervical, triangular area of bladder and urethra of prostate part. Seldom occurred in upper urinary tract.4. B-US, IVU and cystoscope are the common methods of examination for IP, and the cystoscope is the main method.5. Most of IP of urinary tract could be cured by TUR.6. The prognosis of IP is ideal, it was seldom repeaed and cancerated. |
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