LEIOMYOMA OF THE BLADDER

Division of Urology, Paulista School of Medicine, Federal University of Sao Paulo, UNIFESP, SP, BrazilABSTRACTBenign mesenchymal tumors of the bladder are rare and comprise less than 1% of the all bladderneoplasms. Leiomyoma is the most common type and comprises 35% of these tumors. These tumors maydevelop in submucosal (63%), intramural (7%) or subserosal (30%) layer, at any region of the bladder. Theclinical presentation is varied and may include obstructive symptoms (50%), irritative symptoms (38%) andhematuria (11%). There are asymptomatic cases (19%), which make the diagnosis more difficulty. Occursmore frequently in women than in men (3:1) and the majority of leiomyomas presented with a total extent ofbeyond 5 cm. The most common diagnosis exams are ultrasonography (US), intravenous urography andcomputed tomography scan. Recently, the transvaginal US and the magnetic resonance imaging (MRI) appearare useful imaging tools for diagnosis of leiomyoma of bladder.A 38-year-old woman presented with lower abdominal pain and recurrent urinary tract infectionsduring the last 4 years. Various examinations were performed in the last 6 months and none of them determinedthe diagnosis. We performed a transvaginal US, MRI and a cistoscopy with biopsy, confirming the diagnosisof leiomyoma. The surgical exploration revealed a well-circumscribed mass at the posterior bladder wall.The pathological examination revealed a leiomyoma of the bladder. The postoperative period was uneventfuland the patient is doing well, without recurrence of the symptoms, during a 10-months follow-up.Key words: bladder; neoplasms; benign tumor; leiomyomaBraz J Urol, 27: 373-375, 2001