Leiomyoma of vesicovaginal septum causing urinary retention

Para-urethral vaginal leiomyoma

Only a few cases of para-urethral vaginal leiomyoma have been reported in literature. We describe two additional cases and discuss the differential diagnosis and management.

Paraurethral vaginal leiomyoma

A case of paraurethral vaginal leiomyoma becoming clinically apparent in the postpartum period is presented. As is frequently the case, the diagnosis was not apparent. Urinary tract origin is commonly suspected, since the majority of these tumors occur in the midline of the anterior vaginal wall. The tumors are often asymptomatic, but can cause dysuria, urinary frequency, urinary retention, and dyspareunia. Pathologically, they are well circumscribed and have the typical microscopic features of leiomyomas found elsewhere. Simple excision is usually adequate treatment.

Impressions on floor of female bladder: "the female prostate"

The "female prostate" denotes an impression on the base of the female bladder resembling the enlarged male prostate radiographically. Though the finding is widely recognized, confusion exists as to its significance. The differential diagnosis is moderately extensive, and includes retroverted uterus, anterior vaginal tumors, urethral and bladder floor tumors, benign and malignant bony pelvic lesions, urethral diverticulum, and postsurgical changes. Several cases are presented illustrating the previously mentioned causations. An impression on the floor of the female bladder should not be routinely dismissed as inconsequential without thorough evaluation.

Paraurethral leiomyoma--an imitator

In location and clinical appearance a paraurethral leiomyoma imitated other disease in 2 patients. Correct preoperative diagnosis of these lesions can avert therapeutic error. Diagnostic clues include a solid, noncystic mass that does not communicate with the urethra, is circumscribed, and has essentially normal overlying mucosa. A surgical approach through the anterior vaginal wall avoids urethral injury and enucleation is curative.