Uterine Fibroid (Leiomyoma) with Acute Urinary Retention: A Case Series

Abstract

Uterine leiomyomas are an extremely rare cause of acute urinary retention in women. The delay in diagnosing uterine leiomyomas presenting with acute urinary retention further complicates the management. The rarity of the condition makes it difficult to plan either prospective or retrospective trials. Hence, most of the evidence comes from case reports or series. We report a case series of acute urinary retention in women with uterine leiomyomas and discuss the pathophysiology, diagnosis and management options.

Keywords: Myomas; Pathophysiology; Uterine obstruction.

[Table/Fig-2]:

a) Trans abdominal ultrasonography showing posterior myoma (dashed arrow) measuring 7.8 X 6 cm indenting the urinary bladder; bulb of the Foley catheter can also be seen (arrow) and b) The operative specimen showing the large posterior myoma (black arrow) measuring approximately 7 X 6 cm.

[Table/Fig-3]:

Large fundal myoma (black arrow) on right side of uterus measuring 8.5 X 7.5 cm

[Table/Fig-4]:

a) Trans abdominal ultrasonography showing large cervical fibroid (arrow) measuring 9.3 X 9.2 cm with normal sized uterus (dashed arrow) seen on top and b) CECT- large homogenously enhancing solid myoma mass (arrow) measuring 11 X 10.5 cm seen posterior to the bladder (arrow head).

[Table/Fig-5]:

Intraoperative photograph showing normal size uterus (dashed arrow) and large cervical fibroid (arrow) measuring 15 X 10 cm, for which myomectomy was done.

[Table/Fig-6]:

a) Trans abdominal ultrasonography showing anterior wall myoma (arrow) measuring 6.7 X 5.9 cm and b) Intraoperative picture of the anterior myoma (arrow), which measured 7 X 7 cm.