Transurethral resection of a bladder trigone leiomyoma: a rare case report

Abstract

Background Bladder leiomyomas are rare and benign tumors of the bladder. They account for 0.43% of all bladder tumors, and only 250 cases have been reported in English literature. Based on the size and localization of the lesion, their symptoms vary considerably. Women seem to be more affected, and obstructive symptoms predominate. Surgical treatment is almost always highly effective, leaving a low recurrence rate. Case presentation We present a clinical case of a 52-year old man with macroscopic hematuria and obstructive lower urinary tract symptoms due to a large bladder trigone leiomyoma. CT and MRI showed a well-defined large bladder leiomyoma and cystoscopy established the initial findings. The patient underwent successful transurethral resection of the lesion, and pathology findings confirmed the diagnosis. Conclusions This case report demonstrates that transurethral resection of a large bladder trigone leiomyoma is a feasible and successful procedure. Long term follow-up proves that there is neither scarring distortion of the bladder trigone area nor damage in the ureteral orifices, even though there was a thorough removal of the trigone wall.

Imaging findings of atypical leiomyoma of urinary bladder simulating ureterocele

“…Leiomyomas are benign smooth muscle tumors that can occur in any organ [ 4 ]. Leiomyomas of the urinary bladder account for <0.43% of all bladder tumors, with only 250 cases have been reported in the English literatures [ 2 , 4 ]. Despite the increased availability of high-resolution imaging modalities, bladder leiomyomas remain rare tumors [ 5 ].…”

“…It was first described by Kretschmer et al. in 1931 [ 2 ]. The prevalence of these tumors is higher in women than men with a ratio of 2:1 [ 2 ].…”

“…in 1931 [ 2 ]. The prevalence of these tumors is higher in women than men with a ratio of 2:1 [ 2 ]. They affect patients in their fourth to fifth decades of life.…”

“…Leiomyomas may be categorized as endovesical, extravesical or intramural. Endovesical masses have been mostly recognizable (63%); possibly due to its characteristic bulging into the bladder which induced irritative symptoms and forced the patient to seek medical treatment, whereas intramural leiomyomas are present in 3–7% and extravesical in 11–30% [ 2 ]. Bladder leiomyomas are symptomatic in 80% of patients.…”

Robotic transvesical bladder leiomyoma excision

“…While some leiomyomas cause symptoms such as irritative voiding symptoms, hematuria or obstruction, others are diagnosed incidentally. 1 Treatment consists of surgical management which ranges from transurethral resection to partial cystectomy. Few cases of robotic leiomyoma excision exist in current literature.…”