Clinical Analysis of Bladder Leiomyoma

Objective To improve the recognition on the diagnosis and treatment of the leiomyoma of the bladder.Methods The data of 13 patients with bladder leiomyoma(2 male and 11 female) from 1996 to 2008 were analyzed retrospectively.Clinical manifestation included 4 cases with dysuria,3 cases with irritative bladder,3 cases with hematuria,2 cases with hypogastric malaise and 1 case without symptom.B-ultrasonography and CT were available in all 13 cases.Low-echo mass inside bladder was found in 11 cases at the first ultrasonographic examimation and 3 of suffered monolateral hydronephrosis.Soft tissue density shadow was measured by CT and the average CT value was 45.5Hu.High signal mass was on T2-weighted images were recorded by MRI in 4 cases.IVP showed filling defect inside bladder in 7 cases.Three cases were negative in the urinary cytologic examinations.Cystoscopy confirmed 2 tumors and 10 occupying lesions.All cases were performed by operation,tumor enucleation was performed in 9 cases,partial cystectomy in 3 cases and transurethral recection in 1 case.Results Postoperative pathological observation confirmed that the diagnosis of bladder leiomyoma,the mean largest diameter of the tumor was 6.5cm.Most of the surfaces in the tumors were smooth with tenacious and grayish-white sections.It was observed by microscope that the tumor cell differentiated well with rare caryocinesia phase while without heteromorphism.Recurrence and metastases have not be found and the prognosis has well been in all 13 cases postoperatively during follow-up from 6 months to 6 years.Conclusion Leiomyoma of the bladder is benign neoplasm rarely occurred in clinic,whose diagnosis depends on medical imaging.The definitive diagnosis is based on cystoscopy and pathological biopsy.Surgery is the main treatment way and the prognosis is usually well.