title: Female paraurethral leiomyoma: treatment and long-term follow-up.
abstract: BACKGROUND
  We describe our experience with evaluating the ideal management of female paraurethral leiomyomas from imaging to surgery and follow-up.
  
  
  METHODS
  Between January 2009 and January 2012, we treated six women (age range 32-49 years) affected by paraurethral leiomyoma of different sizes.
  
  
  RESULTS
  All the six patients underwent transvaginal excision of the mass. They are free of recurrence at follow-up (range 32-72 months). Two patients developed stress urinary incontinence after the excision: in both cases, incontinence was corrected by a tension-free vaginal tape-obturator (TVT-O) placement. In one patient, a fascial sling was necessary to repair a urethral lesion that developed during surgical excision of the mass.
  
  
  CONCLUSIONS
  A well-defined protocol for diagnosing and managing a paraurethral mass had not been established as yet due the rarity of the mass. We suggest performing pelvic magnetic resonance imaging (MRI) as a primary examination, followed by lesion biopsy. Complete surgical resection performed transvaginally should be the treatment of choice. As paraurethral leiomyomas does not originate from intraurethral smooth-muscle component, urethral lesion is rare. Excision of female urethral leiomyoma transvaginally is safe, and postoperative urinary incontinence, if any, can be easily corrected with minimally invasive tecniques.
authors.affiliation: Division of Urology, A.O. Ordine Mauriziano "Umberto I" Hospital, Largo Turati, 92, 10128, Turin, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Migliari
authors.affiliation: Division of Urology, A.O. Ordine Mauriziano "Umberto I" Hospital, Largo Turati, 92, 10128, Turin, Italy. andreabuffardi.md@gmail.com.
authors.forename: Andrea
authors.identifier: http://orcid.org/0000-0003-1504-7699
authors.initials: A
authors.lastname: Buffardi
authors.affiliation: Division of Pathology, A.O. Ordine Mauriziano Ospedale "Umberto I", Turin, Italy.
authors.forename: Luciano
authors.initials: L
authors.lastname: Mosso
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D061646:Operative Time; D016896:Treatment Outcome; D014523:Urethral Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D014524:Urethral Obstruction / Q000175:diagnosis / Q000209:etiology / Q000601:surgery
keywords: MRI; Paraurethral leiomyoma; Stress urinary incontinence; Transvaginal surgery