Journal of Postgraduate Medicine
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CASE REPORTS
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Year : 1992  |  Volume : 38  |  Issue : 2  |  Page : 79-80  

Leiomyoma of the female urethra.

DS Bhandarkar, RG Tamhane, BP Shenoy, GA Shirodkar 
 Dept of Surgery, JJ Hospital, Byculla, Bombay, Maharashtra.

Correspondence Address:
D S Bhandarkar
Dept of Surgery, JJ Hospital, Byculla, Bombay, Maharashtra.




How to cite this article:
Bhandarkar D S, Tamhane R G, Shenoy B P, Shirodkar G A. Leiomyoma of the female urethra. J Postgrad Med 1992;38:79-80


How to cite this URL:
Bhandarkar D S, Tamhane R G, Shenoy B P, Shirodkar G A. Leiomyoma of the female urethra. J Postgrad Med [serial online] 1992 [cited 2020 Oct 27 ];38:79-80
Available from: https://www.jpgmonline.com/text.asp?1992/38/2/79/712


Full Text




  ::   IntroductionTop


Benign neoplasms of the urethra may arise from any of its histological elements, that is, transitional epithelium, stratified squamous epithelium, glandular epithelium and smooth and striated muscle. Polyps, papillomas, haemangiomas, fibromas, leiomyomas, fibromyomas, neurinomas, neurofibromas, adenomas and cysts have all been reported; polyps and papillomas being the most common and the leiomyomas being among the least common[1]. We present below one such case of leiomyoma of the female urethra.


  ::   Case reportTop


A 32-year-old woman presented with dysuria for three months. She denied any urinary symptoms in the past, not even during her pregnancy, three years earlier. Examination showed a nodular, 3cm x 2cm, freely movable mass anterior to the urethral orifice. Hemogram, serum biochemistry and urinalysis were normal. Cystourethroscopy revealed a mass bulging into the anterior wall of the urethra, and congestion of the overlying urethral mucosa. The mass [Figure:1] was excised under general anaesthesia. Histopathologlical examination of sections stained with H & E [Figure:2A] and with immunoperoxidase staining [Figure:2B] using specific, monocionai, anti-smooth muscle antibody (Desmin) showed the mass to be a leiomyoma.


  ::   DiscussionTop


Leiomyoma of the female urethra is rare and only 28 cases were reported in the world literature till 1988[2]. The symptoms of the tumour comprise dysuria, hematuria and a mass. Obstructive symptoms are rare due to the paraurethral rather than periurethral position of this neoplasm. The tumour has been reported to enlarge during pregnancy and shrink after delivery, suggesting a possible hormonal dependence[1],[2]. The differential diagnosis is from a urethrocele, a urethral diverticulum and urethral malignancy. A leiomyoma can be distinguished from the first two of these three by careful clinical examination, cysto ureth ros copy and radiology of the lower urinary tract. However, only histopathological examination can distinguish it from malignancy. Immunoperoxidase staining employinq aspecific, monoclonal, anti-smooth muscle antibody confirms the smooth muscle origin of this neoplasm. This staining technique was utilised in the present case. Simple surgical excision is the recommended treatment. The prognosis is excellent as malignant transformation has not been reported and recurrence is rare [3].

References

1 Shield DE, Weiss RM. Leiomyoma of the female urethra. J Urol 1973; 109:430-431.
2Fry M, Wheeler JS, Mata JA, Jr. Culkin DJ, St. Martin E, Veneble DD. Leiomyoma of the female urethra. J Urol 1988; 140:613-614.
3Merrell RW, Brown HE. Recurrent urethral leiomyoma presenting as stress incontinence. Urology 1981; 17:588-589.

 
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