Roberto Migliari1, Andrea Buffardi2, Luciano Mosso3. 1. Division of Urology, A.O. Ordine Mauriziano "Umberto I" Hospital, Largo Turati, 92, 10128, Turin, Italy. 2. Division of Urology, A.O. Ordine Mauriziano "Umberto I" Hospital, Largo Turati, 92, 10128, Turin, Italy. andreabuffardi.md@gmail.com. 3. Division of Pathology, A.O. Ordine Mauriziano Ospedale "Umberto I", Turin, Italy.
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.
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.
Entities:
Keywords:
MRI; Paraurethral leiomyoma; Stress urinary incontinence; Transvaginal surgery
Authors: Mário Maciel de Lima Junior; Cleyton Barbosa Sampaio; José Geraldo Ticianeli; Mário Maciel de Lima; Fabiana Granja Journal: J Med Case Rep Date: 2014-11-13