Mitrofanoff polyps: Long-term complication of continent catheterizable channels
Nabeel Ismail, MD1, Michael Daugherty, MD1, Andrew Strine, MD1, Pramod P. Reddy, MD1, W. Robert Defoor, MD1, Eugene Minevich, MD1, Paul Noh, MD1, Zehra Kazmi, MD2, Brian VanderBrink, MD1.
1Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA, 2Agha Khan University Hopital, Karachi, Pakistan.
Inflammatory polyps are a known complication in urinary continent catheterizable channel (CCCs). They can lead to difficultly with catheterization and symptomatic bleeding. However, there is limited data available regarding their management. We aim to describe a large series of polyps occurring in urinary CCCs.
A single institution retrospective review was performed of all patients who developed polyps in urinary CCCs between 2002-2018. Data was collected regarding the type of urinary CCC, associated symptoms, management, and recurrence rates.
A total of 24 patients developed polyps in urinary CCCs. The majority of these polyps developed in an appendicovesicostomy (87%), while only 3 patients (13%) developed polyps in an Ileal Monti. Thirteen (54%) of these polyps were symptomatic. The most common presenting symptom was difficulty with catheterization in 10 patients (77%). An additional 2 patients (15%) had bleeding, while 1 patient (8%) had both difficulty with catheterization and bleeding. For management of these polyps, 37% underwent cystoscopy with snaring using a stone basket, 33% underwent cystoscopy with application of energy to their base, 16% were fulgurated, and only 13% were left in situ. All procedures were performed under general anesthesia. All of the pathology was benign showing chronic inflammatory tissue. Eight polyps recurred after their initial management.
This is the largest series to date of polyps occurring in urinary CCCs. The majority of these polyps were symptomatic and lead to difficulty with catheterization. They can be managed endoscopically but do recur about 1/3 of the time.
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