Laparoscopic partial cystectomy for bladder leiomyoma: case report (SIU 2011)
- uploaded: Jul 15, 2011
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Institution:Azienda Ospedaliero-Universitaria, Catania, Italy
Introduction: Benign mesenchymal tumors are rare and comprise 1 to 5% of all bladder neoplasms . Among them, leiomyoma
is the most common benign neoplasm, accounting for 0.43% of bladder tumors.
We present a case of leiomyoma of the bladder in a female patient and report the treatment.
Method: a 37 years old woman who consulted for solid mass of the bladder. CT scan showed a 10 cm diameter exophitic lesion at the posterior left lateral bladder wall, which protuded into the bladder. The patient complained of urinary frequency; a physical examination did not reveal any particular findings, including pelvic organ prolapse. She denied fever, documented urinary tract infection, or hematuria. We performed cystoscopy and transrethral biopsies of the lesion that demostrated leiomyoma of the bladder. We decided to carry out a laparoscopic partial cistectomy. The operative time was 90 minutes with an intraoperative blood loss of 40 mL. After pneumoperitoneum obtained with open tecnique, we proceeded with trocar positioning : a 10mm port at the umbilicus level for the endocamera, another 5 mm in the left lower quadrant and two 5 mm, one in the right lower quadrant and one at the umbilicus level in a pararectal position. Once located the lesion protruding from the left posterolateral wall, we proceeded to the resection; then specimen retrieval was acomplished with an Endobag and we morcelled it. Bladder closure was done with a running 0 vicryl suture. Postoperative period was uneventful, retrieving the urethral catheter at the 10th postoperative day after cystografy.
Conclusion:leiomyoma is the most common benign tumor of the bladder. It may be asymptomatic or may cause irritative or obstuctive symptoms. The treatment choice depends on the tumor size and localization and relationship with the bladder wall. The laparoscopic approach is an excellent option for tumors located at the mobile wall of the bladder, allowing an easy and safe procedure.
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