Paraurethral leiomyoma in a postmenopausal woman: first European case

Long-term follow up of paraurethral leiomyoma: A case report and literature review

BACKGROUND

Paraurethral fibroid is a rare condition. To date, there is no unified protocol to guide long-term follow up in this condition. This study reviewed case reports and summaries published in the last 10 years and focused on the management plans and follow up of patients with paraurethral fibroids.

CASE PRESENTATION

We report the case of a 44-year-old woman who presented with urinary symptoms. Clinical examination and magnetic resonance imaging revealed an approximately 3 × 3 cm mass which was considered as a paraurethral fibroid. Complete surgical excision was performed. The patient was discharged with no postoperative complications. Histopathology confirmed the diagnosis of a benign leiomyoma.

CONCLUSIONS

Paraurethral fibroid is a rare condition which can be diagnosed with a high level of certainty based on clinical examination and imaging. A multidisciplinary team which includes experienced radiologists and urogynecologists or urologists who have the expertise to perform vaginal surgery with urethral reconstruction is essential for definitive management. Long-term follow up for expected possible complications is advisable. Further research with a larger number of cases is needed to recommend an evidence-based protocol for management of paraurethral fibroid.

What is this vaginal bulge? An atypical case of vaginal paraurethral leiomyoma. A case report and literature systematic review

AIM

Vaginal paraurethral leiomyomas are uncommon benign tumors of the female genitourinary tract. We report a case of anterior vaginal paraurethral leiomyoma. Furthermore, we performed a systematic review of the literature to provide information that can help the physicians in the diagnosis and management of women with this rare pathology.

METHODS

A case of anterior vaginal paraurethral leiomyoma in 53-year-old, primiparous, caucasian woman with history of pelvic pressure, vaginal bulging and overactive bladder symptoms, was described. Furthermore, a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement was performed between January 1, 2000 to Dec 30, 2019. Only articles that reported cases of vaginal or paraurethral leiomyoma (b) case series and case reports with literature review were included.

RESULTS

we screened a total 2281 records; 70 articles published from 2000 to 2019 were included.

CONCLUSION

Vaginal paraurethral leiomyoma is a rare benign tumor of the vagina with a wide spectrum of symptoms and good prognosis. The recurrence and transformation into malignant condition are rare. Histopathological examination is the gold standard for diagnosis, but MRI and US can be help to define the size and localization of the tumor. Management requires surgical vaginal excision in the majority of cases; however, abdominal approach could be considered when it is large and located high in the vagina.

Paraurethral Leiomyoma as an Incidental Finding in Patient with Fibroid Uterus

Paraurethral leiomyomas are rare benign fibromuscular tumors developing from urethra. The presenting symptoms are usually related to mass effect. We present a case of an incidental diagnosis of a paraurethral leiomyoma in a patient with a fibroid uterus. Case was managed by hysterectomy concurrent with periurethral leiomyoma excision. Patient had uncomplicated clinical course. Due to close localization of paraurethral leiomyoma to urethra and bladder care must be taken to minimize the injury during resection.