Paraurethral Leiomyoma During Pregnancy: A Case Report and Review of the Literature

Abstract

Background: A leiomyoma is a benign tumor of smooth-muscle cells that can arise from the genitourinary or gastrointestinal systems. Leiomyomas arising from the urethra or paraurethral areas are uncommon, and there are few reported cases. Case: A 25-year-old female presented with a painless paraurethral swelling during her first trimester of pregnancy. This swelling progressively increased in size, causing obstructive urinary symptoms. Examination under anesthesia was performed, and diagnostic cystoscopy-urethroscopy was performed prior to surgical excision of the mass to ensure that the site of origin had no urethral communication. Results: Histopathologic evaluation confirmed the diagnosis of a leiomyoma. No postoperative complications were noted, and the patient's urinary symptoms were relieved. Conclusions: It is important to differentiate a urethral leiomyoma that presents mainly with obstructive urinary symptoms and requires surgical endoscopic resection from a paraurethral leiomyoma that presents mainly as an asymptomatic freely mobile lump and does not communicate with the urethra, having a clear line of cleavage in between. ( J GYNECOL SURG 36:144

Female paraurethral leiomyoma: A lateral transvestibular approach to a symptomatic tumor

“…In a study involving a significant number of women admitted for surgery due to periurethral masses, the primary pathologies identified were urethral diverticulum (84%), vaginal cysts (7%), and leiomyoma (5%) [2]. Additionally, other potential etiological factors such as urethral caruncles, Skene gland abscesses or cysts, mucosal prolapse, and Gartner's duct cysts may also be observed [3]. In the case of leiomyoma, a transvaginal ultrasonography may report a solid tumor with a homogenous internal echo.…”

“…However, instances of leiomyomas appearing after menopause may challenge this hypothesis [8]. Some argue that leiomyomas originating from the smooth muscle surrounding the urethra are more accurately termed "paraurethral" tumors [9], whereas others define a tumor as urethral if it is firmly attached to the urethra and cannot be dissected without causing mucosal damage [3].…”

Female paraurethral leiomyoma: a case report

“…Paraurethral leiomyomas are benign tumors of mesenchymal origin [2]. The etiology is unknown [3] but the majority of reported cases in reproductive age women explains the hormonal role in its development [4]. Paraurethral leiomyoma affects both genders but has a female preponderance [4] and usual age of presentation is around 40 to 44 years [3].…”

“…The etiology is unknown [3] but the majority of reported cases in reproductive age women explains the hormonal role in its development [4]. Paraurethral leiomyoma affects both genders but has a female preponderance [4] and usual age of presentation is around 40 to 44 years [3]. Patients present with variable symptoms of pelvic pressure, urinary retention, protruding mass, voiding dysfunction lower urinary tract symptoms or vaginal bleeding.…”