Leiomyomas of the female urethra and bladder: a report of five cases and review of the literature

Abstract

Through the experience of five cases of leiomyoma developed in the female bladder and urethra with a review of the literature, we have made an effort to characterize the association of symptom with the size and location of the tumor and demonstrate an appropriate treatment. The study population was composed of patients who underwent surgery for bladder or urethral leiomyoma in our hospital from March 1990 to April 2005. Their medical records were reviewed retrospectively concerning the symptom, size and location of leiomyoma, the result of cystoscope and radiological examination, surgical method, pathologic report, complications, and recurrence. Four cases were diagnosed as urethral leiomyoma and one case as bladder leiomyoma. All patients with urethral leiomyoma were admitted for the chief complaint of a palpable tumor. When the tumor size was small, if it was located on the lateral side of the urethra, it was asymptomatic, but if located in the midline, it presented irritative or obstructive symptom. When it was big, if located on the lateral side, it presented irritative rather than obstructive symptom, and if located in the midline, it presented obstructive symptom. One case of bladder leiomyoma was discovered incidentally during ultrasonic exam. In all five cases, surgical removal was performed and complications or recurrence were not detected afterwards. Bladder and urethral leiomyomas are very rare and cause diverse manifestations from asymptomatic to irritative or obstructive symptom. It is presumed that the location and size of the tumor are associated with symptom. Unless it is the case with severe hemorrhage or obstructive acute renal failure, immediate surgery is not required. However, it is desirable to distinguish leiomyoma from malignant or other benign tumors by surgical biopsy or removal.

Transurethral resection of a bladder leiomyoma: A case report

“…1,2 The most common ones in this category are leiomyomas. They tend to be 30% extravesical, 7% intramural and 63% endovesical.…”

“…There is not a single case of malignant transformation in bladder leiomyomas. [6][7][8][9] The traditional treatment for symptomatic cases is surgical resection. The most important determinants for the choice of surgery are tumour size, localization and its involvement of urinary sphincter or ureter orifices.…”

Open Surgery Following Endourological Treatment in Leiomyoma of the Bladder: Case Report

“…Final diagnosis is made histopathologically. 10,15,16 Bladder leiomyomas were not reported to transform into malign leiomyosarcomas. However, 0.27% of the growing uterine leiomyomas were shown to carry the risk of transforming into leiomyosarcomas.…”

Bladder Leiomyoma Mimicking Uterine Subserous Leiomyoma: A Rare Diagnosis and a Review of the Literature

“…6 Mesane leiomiyomları asemptomatik hastalarda (%19) insidental olarak görülebilmektedirler. Fakat genellikle obstrüktif semptomlar (%49), irritatif semptomlar (%38) ve hematüri (%11) semptomlarıyla görülmek-tedirler.…”