Abstract
Introduction
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.
Conclusion
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.
Similar content being viewed by others
Explore related subjects
Discover the latest articles, news and stories from top researchers in related subjects.References
Dioszeghy F, Kiss A, Kondas J (1998) Leiomyoma of the female urethra. Int Urol Nephrol 30:603–607
Goldman HB, McAchran SE, MacLennan GT (2007) Leiomyoma of the urethra and bladder. J Urol 177:1890
Jalde DD, Godhi SA, Uppin SM, Chako SP, Agrawal AM (2012) A case of urethral leiomyoma – a rare presentation. World J Sci Technol 2:27–28
Buttner C (1894) Ein fall von myom der weiblichen urethra [a case of myoma of the female urethra]. Z Geburshc Gynak 28:135–136
de Lima Junior MM, Sampaio CB, Ticianeli JG, de Lima MM, Granja F (2014) Leiomyoma--a rare benign tumor of the female urethra: a case report. J Med Case Rep 8:366
Pahwa M, Saifee Y, Pahwa AR, Gupta M (2012) Leiomyoma of the female urethra – a rare tumor: case report and review of the literature. Case Rep Urol 2012:280816
Deka PM, Rajeev TP (2003) Leiomyoma of the female urethra – a case report. Urol Int 71:224–225
Perera ND, Senanayake L, Vithana VH, Fernando R (2005) An unusual presentation of female urethral leiomyoma. Ceylon Med J 50:31–33
Hwang JH, Lee JK, Oh MJ, Lee NW, Hur JY, Lee KW (2009) A leiomyoma presenting as an exophytic periurethral mass: a case report and review of the literature. J Minim Invasive Gynecol 16(4):507–9
Blaivas JG, Flisser AJ, Bleustein CB, Panagopoulos G (2004) Periurethral masses: etiology and diagnosis in a large series of women. Obstet Gynecol 103:842–847
Dmochowski RR, Ganabathi K, Zimmern PE, Leach GE (1994) Benign female periurethral masses. J Urol 152:1943–1951
Cattolica EV, Klein R, Knigge W (1976) Paraurethral leiomyoma—an imitator. Urology 8:605–607
Fry M, Wheeler JS Jr, Mata JA et al (1988) Leiomyoma of the female urethra. J Urol 140:613–614
Perugia G, Ciccariello M, Pirolli F et al (2012) Paraurethral Leiomyoma. Urology 79(4):e51–e52
Rivière P, Bodin R, Bernard G, Deligne E, Peyromaure M, Ponties JE (2004) Leiomyoma of the female urethra. Prog Urol 14:1196–1198
Hubert KC, Remer EM, Rackley RR, Goldman HB (2010) Clinical and magnetic resonance imaging characteristics of vaginal and paraurethral leiomyomas: can they be diagnosed before surgery? BJU Int 105(12):1686–1688
Lucioni A, Rapp DE, Gong EM, Fedunok P, Bales GT (2007) Diagnosis and management of periurethral cysts. Urol Int 78:121–125
Cesarani F, Corsico M, Robba T, De Zan A (2000) MR imaging and endorectal sonographic appearance of a cyst of Skene’s ducts. AJR Am J Roentgenol 175:1466–1467
Kato T, Kobayashi T, Ikeda R et al (2004) Urethral leiomyoma expressing estrogen receptors. Int J Urol 11(7):573–575
Oi RH, Poirier-Brode KY (1979) Leiomyoma of the female urethra. J Reprod Med 22:259–260
Wani NA, Bhan BL, Guru AA, Garyali RK (1976) Leiomyoma of the female urethra: a case report. J Urol 116:120–121
Bhandarkar DS, Tamhane RG, Shenoy BP, Shirodkar GA (1992) Leiomyoma of the female urethra. J Postgrad Med 38(2):79–80
Tantbirojn P, Sansopha L, Thanakit V, Sirisubya N (2006) Paraurethral leiomyoma: a case report. J Med Assoc Thail 89(4):545–549
Leung YL, Lee F, Tam PC (1997) Leiomyoma of female urethra causing acute urinary retention and acute renal failure. J Urol 158:1911–1912
Parashar R, Philipraj J, Sasidharan K (2000) Female urethral leiomyoma – a case report. Indian J Urol 16:162–163
Chong KM, Chuang J, Tsai YL, Hwang JL (2006) A rapidly growing paraurethral myoma with profuse bleeding from a mucosal vessel: report of a case. Gynecol Obstet Investig 61:87–89
Goto K, Orisaka S, Kurokawa T, Miyazaki M, Kotsuji F (2005) Leiomyoma of the female urethra: urodynamic changes after surgical intervention. Int Urogynecol J Pelvic Floor Dysfunct 16(2):162–4
Wong MJ, Wong K, Rezvan A, Tate A, Bhatia NN, Yazdany T (2012) Urogenital fistula. Female Pelvic Med Reconstr Surg 18(2):71–8
Migliari R, Pistolesi D, D’Urso L, Muto G (2009) Recurrent pseudodiverticula of the female urethra: five-year experience. Urology 73(6):1218–22
Conflicts of interest
None.
Institutional review board approval
Not requested (this paper represents a report of our experience and not a clinical study).
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Migliari, R., Buffardi, A. & Mosso, L. Female paraurethral leiomyoma: treatment and long-term follow-up. Int Urogynecol J 26, 1821–1825 (2015). https://doi.org/10.1007/s00192-015-2776-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00192-015-2776-8