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Case Reports
. 2025 Jun 25;17(6):e86720.
doi: 10.7759/cureus.86720. eCollection 2025 Jun.

Urethral Leiomyoma in Pregnancy: A Rare Case of Symptomatic Pelvic Mass With Successful Surgical Management

Rana Beloulou Latoui  1 , Abdul Samed Sulemana  2   3 , Minhal Chaudhry  4 , Usama Abbas  5 , Muhammad Abdullah Khan  6
Affiliations
Case Reports

Urethral Leiomyoma in Pregnancy: A Rare Case of Symptomatic Pelvic Mass With Successful Surgical Management

Rana Beloulou Latoui et al. Cureus. .

Abstract

Leiomyomas, benign tumors derived from smooth muscle, are typically found in the uterus. Urethral involvement is an exceptionally rare occurrence, particularly in the context of a pre-fashioned thigh flap. Our case, therefore, presents a unique and intriguing instance, with only a few similar cases reported. We present a case of a 27-year-old primigravida at 11 weeks gestation with a protruding anterior vaginal mass, pelvic heaviness, and recurrent urinary complaints. A well-circumscribed vascular mass came out through the vulval orifice on physical examination. Transvaginal ultrasonography and pelvic magnetic resonance imaging revealed a 6×4 cm-sized mass that originated from the anterior vaginal wall, and it did not invade the adjacent structures. The surgical resection through anterior vaginal route with the use of spinal anesthesia. Histopathological examination revealed urethral leiomyoma, and the diagnosis was supported by positive immunoreactivity for the smooth muscle markers. The recovery following surgery was uneventful, and the pregnancy was carried to term with a successful normal delivery, instilling hope and optimism in similar cases. Our case underscores the crucial role of obstetricians and gynecologists in considering urethral leiomyoma in the differential diagnosis of anterior vaginal wall masses, even in pregnancy. This emphasis on early multimodal treatment can significantly impact the outcome; good results can be achieved, and pregnancy outcomes can be improved with curative therapy.

Keywords: fibroid uterus; leiomyoma; lower urinary tract symptoms; protruding vaginal mass; urethral leiomyoma; uterus like mass.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Protrusion of Urethral Leiomyoma Through Anterior Vaginal Mass
Figure 2
Figure 2. Transvaginal Ultrasound Image Showing a Vascularized Mass Arising From the Anterior Vaginal Wall
Figure 3
Figure 3. Intraoperative View of Urethral Leiomyoma
Figure 4
Figure 4. Surgical Approach and Tumor Dissection of Urethral Leiomyoma
Figure 5
Figure 5. Complete Excision of Urethral Leiomyoma
Figure 6
Figure 6. Histopathological Picture of Excised Mass
Image is showing bundles of smooth muscle cells.
See this image and copyright information in PMC

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