Bladder neck leiomyoma presenting with acute retention of urine in an elderly female

Agrawal, Shailesh; Agrawal, Pallavi; Paliwal, Shweta; Yadav, Chandrajeet

doi:10.4103/0976-7800.127793

Cited by 7 publications

(5 citation statements)

References 10 publications

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“…7 Acute retention of urine is one of the complications in a cervical fibroid, which is managed with cystoscopy and transurethral endoscopic resection. 8 Just as in the case of fibroid uterus the histopathology shows myxoid degeneration, the same thing can be noted in the cervical leiomyoma. 9 …”

Section: Casementioning

confidence: 76%

Interesting Cases of Different Types of Cervical Fibroids

Narmadha¹,

Hameed²,

Radhika³

et al. 2014

jemds

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ABSTRACT:The incidence of cervical fibroids is 0.5-1%. It is usually single; they are usually confined to supravaginal portion of the cervix. Rarely it becomes submucous and polypoidal. So it is usually subserous or interstitial. It can be anterior, posterior or central in position. We had different types of cervical fibroids of which we will describe a few. Usually cervical fibroids cause infertility, difficulty in labor, infections, metrorrhagia, menorrhagia, constipation, retention of urine and dyspareunia. The cervical fibroid distorts the shape of cervix and grows bigger. It pushes the uterus upward giving the appearance of lantern of Saint Paul's dome in a case of a central cervical fibroid. Most of the patients in the reproductive age get admitted for menorrhagia due to fibroid. Its growth is dependent on estrogen. It does not grow after menopause. KEYWORDS: Cervical fibroid, fibroid polyp, hysterectomy. CASE 1:A 52 year old housewife, completed the family, who had previous two LSCS section and sterilization done 20 years ago, got admitted with retention of urine for the past 12 hours. She gave history of burning micturition and frequent retention of urine for which catheterization was done a number of times outside.She had lower abdominal pain and post coital bleeding. She had irregular menstrual history. Foley's catheter was introduced. Bimanual examination showed cervix was replaced by huge mass 8×11 cm occupying the whole cervix and vagina. This was a central cervical fibroid wherein the uterus was found sitting on top of it.The uterus was palpable per abdomen as a soft globular mass2×3 cm suggestive of a fundal fibroid. Patient was anemic and 2 units of blood transfusion were given. Routine investigations were normal. Ultrasound(USG) report showed a small fundal fibroid 2×2 cm and a huge central cervical fibroid of size 8.3×11.3 cm (figure1). Patient was explained and consent for laparotomy was obtained.Laparotomy showed plenty of adhesions due to previous surgeries which were released .The bladder was found plastered with the mass. So a transverse incision was made at the level of the UV fold to push the bladder up. Uterine vessels supplying the fibroid were engorged and tortuous were carefully cut and ligated (figure 2).The uterus along with the central cervical fibroid shelled out without injuring the bladder, ureter and rectum. Pre-operative ureteric stenting could have helped in the surgery of shelling the cervical fibroid. Vault and abdomen closed after perfect hemostasis. The cut section of the specimen showed the uterus sitting on top of the cervical fibroid and had a small fundal fibroid of size 3×3cm.The specimen was sent for histopathology, because of the increased cellularity and mitosis, leiomyosarcoma was thought of initially by the pathologist. Later on, they confirmed it as a feature of highly cellular leiomyoma with hyaline and cystic degeneration (figure 2) Post-operative period was uneventful. Patient passed urine freely. She came for follow up. She had no complaints.

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Section: Casementioning

confidence: 76%

Interesting Cases of Different Types of Cervical Fibroids

Narmadha¹,

Hameed²,

Radhika³

et al. 2014

jemds

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“…Leiomyoma of the bladder neck is rare and presents mainly with obstructive or irritative symptoms. 3 Goluboff et al reviewed the literature on bladder leiomyoma reporting that 49% present with obstructive symptoms, 38% with irritative symptoms, 11% with haematuria and 19% were asymptomatic. 1 Our patient's leiomyoma was asymptomatic for a while until she presented with frank haematuria.…”

Section: Discussionmentioning

confidence: 99%

Rare case presentation of leiomyoma of bladder neck with tuberculous pelvic lymphadenitis in a young female patient

Moawad

Ghashir

Rustum

et al. 2021

Urology Case Reports

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Bladder neck leiomyoma presenting with gross haematuria and clot retention is a rare clinical scenario. A thirty-three-year-old female presented to the emergency department with a history of lower abdominal pain and gross haematuria for a few days. Abdominal and pelvic ultrasonography examination was complimented with CT and MRI scans showing a 7.6 × 7 × 6.5 cm well-defined mass at the bladder base. There was also pelvic and retroperitoneal lymphadenopathy. Laparotomy with enucleation of the mass along with lymph node biopsy was performed with satisfactory control of the bleeding. Histopathology confirmed the diagnosis of leiomyoma of the bladder neck associated with tuberculous lymphadenopathy.

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“…However, bladder leiomyoma smaller than 1.4 cm in diameter can cause pain and urinary retention. 12 This phenomenon is mainly attributed to the location of the tumour. A leiomyoma that is located in the bladder neck may cause more severe symptoms compared with a leiomyoma that is located in the bladder wall.…”

Section: Discussionmentioning

confidence: 99%

Giant leiomyoma of the urinary bladder: A case report

Atallah

Hamdy

Saleh

et al. 2021

UIJ

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Urinary bladder leiomyoma is a rare tumour accounting for less than 0.5% of all urinary bladder tumours. Till now, less than 250 cases were documented with variable sizes, most of them were less than 10 cm in maximum diameter. Here we present a 68- year-old female patient with urinary bladder giant leiomyoma measuring about 13 cm. She presented with right loin pain. Postcontrast computed tomography of the abdomen and pelvis revealed a large posterolateral right-sided urinary bladder mass with moderate right hydroureteronephrosis. It was managed by partial cystectomy. The patient had an uneventful postoperative course. Postoperative pathological examination of the specimen confirmed giant leiomyoma of the urinary bladder.

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Bladder neck leiomyoma presenting with acute retention of urine in an elderly female

Cited by 7 publications

References 10 publications

Interesting Cases of Different Types of Cervical Fibroids

Interesting Cases of Different Types of Cervical Fibroids

Rare case presentation of leiomyoma of bladder neck with tuberculous pelvic lymphadenitis in a young female patient

Giant leiomyoma of the urinary bladder: A case report

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