Bladder neck leiomyoma presenting with acute retention of urine in an elderly female
This was a case report of a 45-year-old female patient presented in the emergency department with painful acute retention of urine. She did not have any history of LUTS prior to this. She was peri-menopausal and had a history of irregular and heavy menstrual period. On examination, urinary bladder was palpable and tender. Pelvic examination did not reveal any pelvic organ prolapse or mass. Ultrasonography was carried out prior to catheterization, which revealed a small growth at the bladder neck []. Growth was about 1.4 cm and had hyper echoic peripheral rim with sonolucent center with fine internal echoes. Results of laboratory investigations were within normal limit. On cystourethroscopy, small mass with smooth urothelial covering was present at the bladder neck extending onto proximal urethra []. Mass was extending from 10 o'clock to 2 o'clock position at the bladder neck. It was resected completely using 26 F continuous flow resectoscope and cutting loop electrode []. It was solid to cut and did not bleed much. Special care was taken to preserve the bladder neck. An 18 F two way Foley's catheter was kept for 2 days. Patient voided with good flow after catheter removal. At 6 months follow-up, patient was symptoms free and ultrasound of the bladder was normal.\nThe pathological findings revealed the proliferation of spindle-shaped cells with eosinophilic cytoplasm, muscular and fibrous tissue with fibrous stoma. The nuclei of the cells were cigar-shaped and centrally located. No evidence of mitotic figures, coagulative T-cell necrosis or atypia was seen. Hence, findings were consistent with a diagnosis of benign leiomyoma [].