Distal urethral fibroepithelial polyp in a 2-year-old female: A Case Report

Authors

Abstract

Introduction Fibroepithelial polyps (FEPs) of the urethra are rare benign mesenchymal tumors, predominantly occurring in the posterior urethra of male children. Their occurrence in the distal urethra of female children is exceptionally rare.
Case Presentation A 2-year-old female presented with a 2.5 cm pedunculated, fleshy mass protruding from the distal urethral meatus. The lesion was identified as an interlabial mass that became more prominent during straining. The patient underwent complete surgical excision using a vessel-sealing device at the Department of Pediatric Surgery. Histopathological analysis confirmed the diagnosis of a fibroepithelial polyp.
Conclusion Although rare, FEP should be considered in the differential diagnosis of interlabial masses in prepubertal girls. Surgical excision is curative with an excellent prognosis.

Keywords

Introduction

Fibroepithelial polyps (FEPs) are benign, non-epithelial tumors of mesodermal origin that can occur throughout the urinary tract.¹ While they are the most common benign tumors of the ureter, their occurrence in the urethra is rare, especially in the pediatric population.² Historically, urethral FEPs have been described almost exclusively in male children, typically arising from the verumontanum in the posterior urethra.³ In female children, the presentation of a urethral polyp is considered exceptional.⁴ These lesions often present as an interlabial mass, which can lead to diagnostic confusion with more common conditions such as urethral prolapse, paraurethral cysts, or more serious malignancies like rhabdomyosarcoma.⁵

Case Presentation

A 2-year-old female was brought to the pediatric surgery clinic with a complaint of a visible mass in the genital area. Physical examination in the frog-leg position revealed a pedunculated, reddish-pink, fleshy mass approximately 2.5 cm in length protruding from the distal urethral meatus (Figure 1). Under general anesthesia, the patient underwent surgical excision. A simple polypectomy was performed at the base of the stalk using a vessel-sealing device (LigaSure) to ensure precise hemostasis (Figure 2). A temporary urethral catheter was placed and removed after 24 hours. The patient was discharged on the first postoperative day without complications. Macroscopic examination revealed a 2.5 x 2.0 x 0.5 cm polypoid tissue fragment. Microscopic analysis showed a core of loose, vascularized fibroconnective stroma covered by benign squamous and transitional epithelium, confirming the diagnosis of a fibroepithelial polyp.
Ethical ApprovalThis study did not require ethical approval according to the relevant guidelines. Informed consent was obtained from the patient's legal guardians.
Reporting GuidelinesThis case report was prepared in accordance with the CARE guidelines.

Discussion

Urethral FEPs in children are rare, and their occurrence in females is even more so. A review of the literature suggests that fewer than 20 cases of female urethral polyps have been described in detail.⁶ Most pediatric urethral polyps are congenital and are thought to arise from an error in the development of the wall of the urogenital sinus.⁷ The presentation of an interlabial mass in a young girl requires a broad differential diagnosis, including urethral prolapse, paraurethral cysts, and rhabdomyosarcoma.⁸

Limitations

The main limitation of this study is the single-case nature and the lack of long-term follow-up data beyond the immediate postoperative period.

Conclusion

Distal urethral fibroepithelial polyps are a rare but important cause of interlabial masses in female children. Clinicians should maintain a high index of suspicion to differentiate these benign lesions from more aggressive pathologies. Complete surgical excision provides both a definitive diagnosis and a permanent cure.

Declarations

Abbreviations

CARE: case report guidelines
FEP: fibroepithelial polyp

References

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About This Article

Received:

January 20, 2026

Accepted:

March 31, 2026

Published Online:

April 4, 2026