Bladder Outlet Obstruction Due to Bladder Leiomyoma – Case Report and Literature Review

Bladder Leiomyoma is a rare and benign disease with a variable clinical presentation. The use of imaging exams is necessary for both diagnostic confirmation and therapeutic programming. The objective of this work was to report the case of a patient diagnosed with bladder leiomyoma and treated at our service and to make a brief review in the literature about the subject. A 50-year-old female patient who presented with symptoms of the lower urinary tract, evolving to acute urinary retention and need for a bladder catheter. She was submitted to a magnetic resonance imaging (MRI) of the pelvis showing nodular oval formation of 3.7x3.7x3.1cm, located in the inferior vesical wall with apparent submucosal origin, bulging the external lower and lateral contour of the bladder and inseparable from the third proximal of the urethra. She was submitted to a transvaginal biopsy of the lesion guided by ultrasound (US) with histopathological report evidencing spindle-shaped cells with eosinophilic cytoplasm and cigar-shaped nuclei characterizing leiomyoma. Afterwards, she was submitted to laparoscopic excision of the bladder lesion requiring bladder suture with a bilaterally double J stent implant (previously to the abdominal access) and a bladder catheter implant after the procedure. The bladder catheter was removed on the 21th postoperative day, with no voiding complaints. The double J stents were removed on the 45th postoperative day.