[Leiomyoma of the bladder. Report of a case and review of the literature].

Mesoidial tumours are rare benign lesions which may occur wherever mesenchymal tissues are present with an incidence of between 1.5% and 5%. Above all, leiomyomas affect females affect females aged between 30 and 50 years old and show a preference for the uterus (most frequently observed site) and the digestive and urinary tracts, in particular the vescica. Their etiology is still controversial, but the hypothesis of tumoral growth following an altered response to hormone stimulation (spt. Estrogens) appears to be the most credible. Development is mainly endovescical (63%), but extravescical (30%) and intramural cases are not rare; the site and dimensions (mean 6 cm) influence the symptoms, the type of surgery and the prognosis. In intravescical cases the most commonplace symptoms include obstructive urination, including pre-urination delay, a feeling of incomplete emptying, diurnal pollakiuria; these are followed by irritative symptoms (dysuria, burning) and micro-macroscopic hematuria. They are often asymptomatic in other cases. Diagnosis is based on instrumental diagnosis, in particular ultrasonography using a suprapubic and/or transvaginal approach, which gives an hypoechogenic image covered by a thin hyperechogenic line of mucosa. Diagnosis can also be made using CAT and, in some cases, MR for a better definition of the site, dimensions and ratios. Urethrocystoscopy is essential in asymptomatic cases and allows biopsy to be performed in uncertain cases. Treatment is surgical using a transurethral approach in endovescical cases with limited dimensions or open surgery in others. Depending on timely treatment, prognosis is good owing to the low number of recidivations.