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Zachariou A, Filiponi M, Dimitriadis F, Kaltsas A, Sofikitis N. Transurethral resection of a bladder trigone leiomyoma: a rare case report. BMC Urol 2020; 20:152. [PMID: 33028269 PMCID: PMC7542762 DOI: 10.1186/s12894-020-00722-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 09/16/2020] [Indexed: 12/27/2022] Open
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.
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Affiliation(s)
- Athanasios Zachariou
- Urology Department, Medical School, University of Ioannina, 3 Spyridi Street, 38221, Vólos, Greece.
| | - Maria Filiponi
- Urology Department, Medical School, University of Ioannina, 3 Spyridi Street, 38221, Vólos, Greece
| | - Fotios Dimitriadis
- 1st Urology Department, Medical School, Aristotle University of Thessaloniki, Thessaloníki, Greece
| | - Aris Kaltsas
- Urology Department, Medical School, University of Ioannina, 3 Spyridi Street, 38221, Vólos, Greece
| | - Nikolaos Sofikitis
- Urology Department, Medical School, University of Ioannina, 3 Spyridi Street, 38221, Vólos, Greece
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Incidental Asymptomatic Leiomyoma of the Urinary Bladder. Urology 2017; 113:6-9. [PMID: 29122624 DOI: 10.1016/j.urology.2017.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 10/17/2017] [Accepted: 10/19/2017] [Indexed: 11/20/2022]
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Saadi A, Bouzouita A, Cherif M, Ayed H, Derouiche A, Ben Slama RM, Chebil M. [Not Available]. Can Urol Assoc J 2015; 9:E471-5. [PMID: 26279718 DOI: 10.5489/cuaj.2837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Introduction : Les léiomyomes sont des tumeurs mésenchymateuses bénignes. La localisation vésicale de ces tumeurs est rare et représente moins de 0,5 % de toutes les tumeurs vésicales. Le léiomyome vésical est la plus fréquente de ces tumeurs mésenchymateuses et il représente le tiers des lésions bénignes de la vessie. Notre but était d’étudier les particularités épidémiologiques, cliniques, radiologiques, thérapeutiques et évolutives de ce type de tumeur.Matériel et méthodes : Nous rapportons une série de cinq cas de léiomyome vésical, colligés entre 2001 et 2014. Il s’agit de trois femmes et de deux hommes. La symptomatologie clinique est non spécifique et dominée par la cystite. Trois patients ont eu une énucléation et deux ont eu une résection endoscopique de la tumeur.Résultats : Le suivi moyen est de six ans. Un seul patient a présenté une récidive expliquée par la persistance d’un nodule vésical lors de la première intervention, avec une bonne évolution après la deuxième cure chirurgicale.Conclusion : Le léiomyome vésical est une tumeur bénigne et rare. Sa symptomatologie est peu spécifique. Son diagnostic est histologique. Son traitement est toujours chirurgical, offrant un excellent pronostic, sous réserve d’une exérèse complète pour éviter les récidives.
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Affiliation(s)
- Ahmed Saadi
- Service d'urologie, Hôpital Charles Nicolle, Tunis, Tunisie
| | | | - Mohamed Cherif
- Service d'urologie, Hôpital Charles Nicolle, Tunis, Tunisie
| | - Haroun Ayed
- Service d'urologie, Hôpital Charles Nicolle, Tunis, Tunisie
| | | | | | - Mohamed Chebil
- Service d'urologie, Hôpital Charles Nicolle, Tunis, Tunisie
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Khater N, Sakr G. Bladder leiomyoma: Presentation, evaluation and treatment. Arab J Urol 2013; 11:54-61. [PMID: 26579246 PMCID: PMC4442969 DOI: 10.1016/j.aju.2012.11.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 11/21/2012] [Accepted: 11/21/2012] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Bladder leiomyomas are benign mesenchymal neoplasms and very rare urinary tumours that represent <0.5% of all bladder tumours, with only 250 cases reported worldwide to date. The importance of recognising their characteristic features, leading to their correct treatment, is fundamental. Therefore, we reviewed reports of leiomyomas of the urinary bladder, their causes, clinical presentations, imaging methods and surgical management, updated to 2012. METHODS We retrospectively reviewed articles published in the USA, Europe and Asia, from 1953 to date, using PubMed, Medscape, Medline and the several major journals. We report areas of controversies and well-established guidelines. RESULTS We reviewed 36 articles that confirmed, with a high level of evidence-based medicine, that the male to female ratio is equal, the cause of bladder leiomyomas remains unknown, and their most common presentation is obstructive uropathy; endovesical tumours are the most common. Their radiological diagnosis can be made by ultrasonography, computed tomography or magnetic resonance imaging. Complete surgical resection is a very effective treatment, associated with almost no recurrence. CONCLUSION In symptomatic patients a complete surgical resection can give a very good outcome, with almost no recurrence.
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Affiliation(s)
- Nazih Khater
- Rafik Hariri University Hospital, Division of Urology, American University of Beirut, Beirut, Lebanon
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Park JW, Jeong BC, Seo SI, Jeon SS, Kwon GY, Lee HM. Leiomyoma of the urinary bladder: a series of nine cases and review of the literature. Urology 2010; 76:1425-9. [PMID: 20947147 DOI: 10.1016/j.urology.2010.02.046] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2009] [Revised: 02/15/2010] [Accepted: 02/15/2010] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To present our experience with 9 cases of bladder leiomyomas and a review of the relevant published data. METHODS During a 13-year period, 9 patients were treated for bladder leiomyoma. Their medical records were retrospectively reviewed, and data, including age, sex, symptoms, tumor size and location, cystoscopy results, radiologic examination findings, method of extirpation, pathology slides, and follow-up results, were analyzed. RESULTS All 9 patients were women, with a mean age of 43.6 years (range 24-65). Of the 9 patients, 5 reported urinary symptoms, 1 presented with gross hematuria, and 3 were asymptomatic. The mean tumor size was 4.2 cm (range 2.4-7). The tumor size was larger in symptomatic patients than in the asymptomatic patients. All tumors were endovesical lesions; 1 patient had a concomitant extravesical tumor. Transurethral resection was performed in 6 patients, partial cystectomy in 2, and enucleation in 1. Microscopically, the tumors were composed of bland, spindle-shaped cells. Recurrence developed in 2 patients. Both patients underwent repeat resection, and no additional recurrence developed. CONCLUSIONS Leiomyoma of the bladder is rare and occurs predominantly in women. The size, rather than the location, of the tumor appeared to be more closely related to the occurrence of symptoms. Surgical excision is the standard approach to diagnosis and treatment.
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Affiliation(s)
- Jong Wook Park
- Department of Urology, Korea Cancer Center Hospital, Seoul, Republic of Korea
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Bai SW, Jung HJ, Jeon MJ, Jung DJ, Kim SK, Kim JW. Leiomyomas of the female urethra and bladder: a report of five cases and review of the literature. Int Urogynecol J 2007; 18:913-7. [PMID: 17333443 DOI: 10.1007/s00192-006-0257-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2006] [Accepted: 10/25/2006] [Indexed: 11/25/2022]
Abstract
Through the experience of five cases of leiomyoma developed in the female bladder and urethra with a review of the literature, we have made an effort to characterize the association of symptom with the size and location of the tumor and demonstrate an appropriate treatment. The study population was composed of patients who underwent surgery for bladder or urethral leiomyoma in our hospital from March 1990 to April 2005. Their medical records were reviewed retrospectively concerning the symptom, size and location of leiomyoma, the result of cystoscope and radiological examination, surgical method, pathologic report, complications, and recurrence. Four cases were diagnosed as urethral leiomyoma and one case as bladder leiomyoma. All patients with urethral leiomyoma were admitted for the chief complaint of a palpable tumor. When the tumor size was small, if it was located on the lateral side of the urethra, it was asymptomatic, but if located in the midline, it presented irritative or obstructive symptom. When it was big, if located on the lateral side, it presented irritative rather than obstructive symptom, and if located in the midline, it presented obstructive symptom. One case of bladder leiomyoma was discovered incidentally during ultrasonic exam. In all five cases, surgical removal was performed and complications or recurrence were not detected afterwards. Bladder and urethral leiomyomas are very rare and cause diverse manifestations from asymptomatic to irritative or obstructive symptom. It is presumed that the location and size of the tumor are associated with symptom. Unless it is the case with severe hemorrhage or obstructive acute renal failure, immediate surgery is not required. However, it is desirable to distinguish leiomyoma from malignant or other benign tumors by surgical biopsy or removal.
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Affiliation(s)
- Sang Wook Bai
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Shinchon-dong 134 Seodaemun-gu, 120-752, Seoul, South Korea.
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Chen CC, Huang CH, Chu CH, Su CM, Chou YH, Chai CY, Shih MC. Leiomyoma of the urinary bladder: a case report. Kaohsiung J Med Sci 2003; 19:141-5. [PMID: 12751876 DOI: 10.1016/s1607-551x(09)70463-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Leiomyoma of the urinary bladder is a rare tumor and constitutes 35% of benign mesenchymal bladder tumors. Herein, we report a case of leiomyoma of the bladder. A 32-year-old female was incidentally found to have an abnormal bladder mass on abdominal ultrasound during work-up for infertility. Bimanual examination then revealed a mass on the right side near the bladder neck area. On cystoscopic examination, an external compression mass covered with normal bladder mucosa could be seen at the right lateral wall. Computerized tomography revealed a homogeneous solitary tumor protruding into the urinary bladder from the right lateral wall without enlarged lymph nodes. Magnetic resonance imaging showed an intraluminal round mass at the right aspect of the urinary bladder, leading to suspicion of an intramural neurogenic or mesenchymal tumor. Surgical exploration was performed via a lower midline incision and a 5.0 x 4.5 x 2.2 cm mass was excised. The pathologic diagnosis was leiomyoma of the bladder. We discuss the diagnosis and management of leiomyoma of the bladder and briefly review the literature.
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Affiliation(s)
- Chung-Chin Chen
- Department of Urology, Kaohsiung Medical University, Kaohsiung, Taiwan
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Deliveliotis C, Giannakopoulos S, Zougri S, Kostakopoulos A, Kastriotis J. Leiomyoma of the bladder: a case report. Int Urol Nephrol 1998; 30:141-3. [PMID: 9607883 DOI: 10.1007/bf02550568] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A case of leiomyoma of the urinary bladder in a 20-year-old man is reported. The patient presented with severe frequency and perineal burning at the end of urination along with microscopic haematuria. Enucleation of the tumour was performed because transurethral biopsy revealed leiomyoma. The prognosis of these tumours is excellent.
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Affiliation(s)
- C Deliveliotis
- Department of Urology, University of Athens, School of Medicine, Greece
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Cornella JL, Larson TR, Lee RA, Magrina JF, Kammerer-Doak D. Leiomyoma of the female urethra and bladder: report of twenty-three patients and review of the literature. Am J Obstet Gynecol 1997; 176:1278-85. [PMID: 9215185 DOI: 10.1016/s0002-9378(97)70346-6] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Our purpose was to review what may be the largest experience of bladder and urethral leiomyomas from a single institution. STUDY DESIGN 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.
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Affiliation(s)
- J L Cornella
- Department of Gynecologic Surgery, Mayo Clinic Scottsdale, Mayo Graduate School of Medicine, AZ 85259, USA
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Abstract
We recently treated a patient with leiomyoma of the bladder and reviewed the 37 most recent cases in the English language literature. Mean patient age was forty-four years. Women made up 76 percent of the patients. Patients presented most commonly with obstructive urinary symptoms (49%), irritative symptoms (38%), hematuria (11%), or flank pain (13%); 19 percent were asymptomatic. Almost all patients had cystoscopy (87%) and intravenous urograms (IVU) (81%), but fewer had masses on bimanual examination (57%), ultrasound (49%), or computed tomography (CT) scan (35%). Most patients were treated with open resection (62%), while 30 percent were treated with transurethral resection (TUR). Almost all patients were cured with a single procedure (89%). Leiomyoma of the bladder is rare and readily cured with excision.
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Affiliation(s)
- E T Goluboff
- Department of Urology, College of Physicians and Surgeons, Columbia University, New York, New York
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Kabalin JN, Freiha FS, Niebel JD. Leiomyoma of bladder. Report of 2 cases and demonstration of ultrasonic appearance. Urology 1990; 35:210-2. [PMID: 2180171 DOI: 10.1016/0090-4295(90)80032-i] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Two cases of bladder leiomyoma are reported. Both are women who presented with a palpable mass on pelvic examination, one asymptomatic and the second with significant bladder outlet obstruction. Results of ultrasound examinations are presented. Complete local resection was curative in both patients.
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Affiliation(s)
- J N Kabalin
- Division of Urology, Stanford University Medical Center, California
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Abstract
We report 5 cases of leiomyoma of the bladder and review the literature. Because of its size and location, this tumor usually is asymptomatic unless urinary tract function is affected. Excretory urography and computerized tomography were useful in identifying the location, consistency and size of the lesions. Small lesions can be managed with transurethral resection and large lesions require segmental resection. Cystectomy is not indicated.
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Abstract
A case of acute urinary retention due to a vesical leiomyoma is described. This is an unusual presentation and the treatment is discussed.
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Abstract
Leiomyomas may originate from any anatomic location of smooth muscle in the genitourinary system but are uncommon neoplasms. Five unusual cases of leiomyomas arising from the renal pelvis, bladder, spermatic cord, and glans penis are presented. The leiomyoma arising from the glans penis in a three-year-old boy is the first case of a leiomyoma in that location noted in the literature. A review of leiomyomas from each genitourinary structure of origin is presented.
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