Vaginal leiomyoma--an imitator of prolapse.
Vaginal leiomyoma is a rare tumor with a variable clinical presentation and broad differential diagnosis that can lead to preoperative misdiagnosis. We present a case of vaginal leiomyoma with a symptom complex of prolapse, urinary urgency and urge incontinence. A 50-year-old woman presented with a 4-year history of deteriorating sensation of prolapse, significant complex urinary complaints and prolonged vaginal bleeding. Clinical examination revealed a mobile 6 x 8 cm mass arising from the anterior vaginal wall. She underwent hysteroscopy, curettage, urethrocystoscopy (normal findings) and mass enucleation through a vertical incision. Histology showed a benign leiomyoma. Ultrasonography, MRI, positive-pressure urethrography and urethrocystoscopy should be considered in the evaluation of an anterior wall vaginal mass. Surgical enucleation via a vaginal approach is the treatment of choice. If this surgical procedure results in skeletonization of the urethral and bladder support, a colporrhaphy/pubourethral ligament plication is required.
Leron
E
E
St. George's Hospital Medical School, London, UK.
Stanton
S L
SL
D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged; D014549:Urinary Incontinence / Q000175:diagnosis / Q000209:etiology; D014596:Uterine Prolapse / Q000175:diagnosis*; D014625:Vaginal Neoplasms / Q000150:complications / Q000175:diagnosis*