Laparoscopic management of a large urethral leiomyoma

  • Giuseppe Ciravolo
  • Federico FerrariEmail author
  • Valentina Zizioli
  • Paolo Donarini
  • Sara Forte
  • Enrico Sartori
  • Franco Odicino
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Introduction and hypothesis

A 42-year-old female presented with a 12-cm mass bulging the anterior vaginal wall and causing urgency urinary incontinence and bulk symptoms.


Imaging showed a tumor originating from the dorsal and cranial part of the urethra and developing in the vesicouterine space and vesicovaginal septum, dislocating the bladder ventrally and the uterus cranial-dorsally.


Tranvaginal biopsy showed a benign leiomyoma. A laparoscopic approach with development of the vesicouterine space permitted a safe partial morcellation of the myoma. After the bladder and vaginal wall had been completely freed, further caudal dissection was conducted with isolation of the distal cranio-dorsal portion of the urethra. The dissection plane with the vaginal wall was developed up to the caudal margin of the urethral myoma almost corresponding to the vulvar plane, and total excision of the lesion was performed.


Laparoscopic management of urethral leiomyomas that develop into the vesicouterine space and vesicovaginal septum is feasible and safe also for very large lesions.


Urethra Benign leiomyoma Urethral leiomyoma Laparoscopy 



This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

Each author declares that there are no conflicts of interest and nothing to disclose.


Written informed consent was obtained from the patient for publication of this case report and any accompanying images.


  1. 1.
    Donnez J, Dolmans M-M. Uterine fibroid management: from the present to the future. Hum Reprod Update. 2016;22(6):665–86.CrossRefGoogle Scholar
  2. 2.
    Bai SW, Jung HJ, Jeon MJ, Jung DJ, Kim SK, Kim JW. Leiomyomas of the female urethra and bladder: a report of five cases and review of the literature. Int Urogynecol J. 2007;18(8):913–7.CrossRefGoogle Scholar
  3. 3.
    Cicilet S, Joseph T, Furruqh F, Biswas A. Urethral leiomyoma: a rare case of voiding difficulty. BMJ Case Rep. 2016;2016:bcr2016216728.CrossRefGoogle Scholar
  4. 4.
    Joshi HB, Beck RO. Leiomyoma of the female urethra with upper tract dilation and treatment with transurethral resection: a case report and literature review. Tech Urol. 2000;6(3):223–5.Google Scholar
  5. 5.
    Majd HS, Ferrari F, Gubbala K, Campanile RG, Tozzi R. Latest developments and techniques in gynaecological oncology surgery. Curr Opin Obstet Gynecol. 2015;27(4):291–6.CrossRefGoogle Scholar
  6. 6.
    Fedelini P, Chiancone F, Fedelini M, et al. A very large leiomyoma of the urethra: a case report. Urol J. 2018;85(2):79–82.CrossRefGoogle Scholar

Copyright information

© The International Urogynecological Association 2019

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologySpedali Civili BresciaBresciaItaly
  2. 2.Department of Obstetrics and GynecologyUniversity of BresciaBresciaItaly

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