Leiomyoma of the urinary bladder: clinical features and laser resection technique

Introduction. Most bladder tumors are represented by transitional cell carcinoma, while leiomyomas account for less than 0.5% of cases. The extreme rarity of this mesenchymal tumor leads to diagnostic challenges and the absence of unified treatment protocols. The management strategy depends on the location and size of the lesion.

Objective. To describe the surgical technique and clinical features of bladder leiomyoma in a female patient.

Case presentation. We report a clinical case of a 65-year-old woman diagnosed with bladder leiomyoma. Ultrasonography, contrast-enhanced magnetic resonance imaging, and urine cytology were performed for diagnosis. The patient underwent transurethral laser enucleoresection using a U-max thulium fiber laser. The operation lasted 35 minutes without intraoperative complications. In the early postoperative period, following the removal of the urethral catheter, the patient developed voiding difficulties, subfebrile fever, and pelvic pain syndrome, requiring repeat bladder catheterization. Histological examination confirmed the diagnosis of bladder leiomyoma.

Clinical discussion. Bladder leiomyoma is a benign mesenchymal tumor. The absence of standardized treatment guidelines necessitates an individualized therapeutic approach. Various surgical options have been described, but transurethral resection remains the primary method. Endoscopic intervention is minimally invasive, provides shorter hospital stays, and promotes rapid rehabilitation. In cases of pronounced extravesical growth, open or laparoscopic resection is preferable due to the risk of intraoperative bladder perforation.

Conclusion. The presented clinical case demonstrates that transurethral laser enucleoresection is an effective and safe method for bladder leiomyoma treatment, ensuring complete removal with minimal trauma. Early comprehensive diagnostics and individualized surgical management result in a favorable prognosis for this rare pathology.

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