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Laparoscopic management of a large urethral leiomyoma

  • Giuseppe Ciravolo
  • Federico FerrariEmail author
  • Valentina Zizioli
  • Paolo Donarini
  • Sara Forte
  • Enrico Sartori
  • Franco Odicino
IUJ Video

Abstract

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.

Methods

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.

Results

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.

Conclusion

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

Keywords

Urethra Benign leiomyoma Urethral leiomyoma Laparoscopy 

Notes

Funding

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.

Consent

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

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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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