Leiomyoma of the female urethra and bladder: report of twenty-three patients and review of the literature.
OBJECTIVE
Our purpose was to review what may be the largest experience of bladder and urethral leiomyomas from a single institution.


METHODS
A retrospective review was done of 23 female patients with emphasis on presentation, symptoms, and operative approach for excision.


RESULTS
The majority of bladder and urethral leiomyomas in this series were asymptomatic, nonobstructive, or incidental (discovered at surgery for another entity). Ten patients had a palpable mass on physical examination. Two patients had pain as a presenting complaint. The route of operative excision was transvaginal (10 patients), transurethral (6 patients), or abdominal (6 patients). One patient had the leiomyoma removed elsewhere with a resultant vesicovaginal fistula.


CONCLUSIONS
Corollaries should be sought with the experience of uterine leiomyomas, which are histologically identical to bladder leiomyomas. Asymptomatic, nonobstructive, and nonproblematic leiomyomas should not serve as an indication for primary operation. Pedunculated endovesical lesions may be an exception because of the ease of transurethral removal and their tendency to cause future symptoms. Ultrasonographic imaging, cystoscopy, and biopsy should be considered to allow observation and follow-up of leiomyomas. Future investigative cytogenetic studies should be considered on these mesenchymal tumors.
Cornella
J L
JL
Department of Gynecologic Surgery, Mayo Clinic Scottsdale, Mayo Graduate School of Medicine, AZ 85259, USA.
Larson
T R
TR
Lee
R A
RA
Magrina
J F
JF
Kammerer-Doak
D
D
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D012189:Retrospective Studies; D014463:Ultrasonography; D014521:Urethra / Q000000981:diagnostic imaging / Q000473:pathology; D014523:Urethral Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D001743:Urinary Bladder / Q000000981:diagnostic imaging / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery