FEMALE PARAURETHRAL LEIOMYOMA: OUR 5-YEAR EXPERIENCE
To evaluate the ideal management of female paraurethral leiomyomas, from imaging to surgery and follow-up. We described or experience.
Patients and methods
Between January 2009 and January 2012 we have treated 6 women (age range 32-49 years) affected by paraurethral leiomyoma of different size. All patients were studied with a pelvic MRI and a transvaginal ultrasound-guided biopsy of the paraurethral mass.
All the 6 patients underwent transvaginal excision of the paraurethral mass. They are free of recurrence at follow-up (range follow-up 32 to 72 months). Two patients developed a stress urinary incontinence after the paraurethral mass excision: in both cases the incontinence was successfully corrected by a TVT-O placement. In one patient a fascial sling was necessary to repair an urethral lesion developed during surgical excisione of the mass.
Because of its rarity, a well-defined protocol for the diagnosis and management of a paraurethral mass had not been established. We suggest to perform pelvic MRI as a primary examination followed by biopsy of the lesion. Transvaginal complete surgical resection should be the treatment of choice. As the paraurethral leyomioma does not originates from intraurethral smooth muscle component, the lesion of the urethra is rare.
Transvaginal excision of female urethral leiomyoma is safe. Postoperative urinary incontinence, if any, can be easily corrected with minimally-invasive tecniques.