Introduction: The aim of this study was to observe the natural course of polypoid lesions of the ureter encountered during ureteroscopic stone treatment. Methods: Patient data were gathered prospectively from six teaching hospitals between August 2019 and July 2021. Patients with polypoid lesions in the ureter distal to ureteral stones during ureteroscopy were enrolled in the present study. Computed tomography was performed in all enrolled patients three months postoperatively. However, the determination of follow-up ureteroscopy was contingent solely on each patient’s willingness, because of the need to undergo general anesthesia again and ethical considerations. Results: Among 35 followed up patients, 14 exhibited fibroepithelial polyps and 21 were confirmed as having inflammatory polyps. Twenty (57.1%) of the followed-up patients underwent ureteroscopy; of these, nine patients had fibroepithelial polyps. Although fibroepithelial polys did not disappear in the follow-up ureteroscopy (p = 0.002), the rate of postoperative hydronephrosis was not higher in the fibroepithelial group than it was in the inflammatory group. The postoperative ureteral stricture and moderate-to-severe hydronephrosis were found to be closely related to the number of resected polyps regardless of the type of polyp (p = 0.014 and 0.006, respectively). Conclusions: The fibroepithelial polyp of the ureter may persist after treatment of adjacent urolithiasis. However, conservative management may be preferable to the active removal of ureteral polyps, because fibroepithelial polyps may not contribute to clinically significant postoperative hydronephrosis, and inflammatory polyps disappear spontaneously. Rather impellent resections of polyps may increase the risk of ureteral stricture. SOURCE OF Funding: The authors wish to acknowledge the financial support of the St. Vincent’s hospital, the research institute of medical science (SVHR-2018-06). In part, the present study was also supported by a grant from the Korean society of endourology and robotics in the program year of 2019.
