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IP35-08 CLINICAL PATTERNS AND PATHOGENESIS OF BLADDER LEIOMYOMA: A MULTICENTER OBSERVATIONAL STUDY
Abstract   Peer reviewed

IP35-08 CLINICAL PATTERNS AND PATHOGENESIS OF BLADDER LEIOMYOMA: A MULTICENTER OBSERVATIONAL STUDY

Lory Hage, Mohamad Abou Chakra, Michael O'Donnell, Frédéric Panthier, Thibault Germain, Mickael Userovici, Johnny Boustany, Alexandra Clerget, Arthur Peyrottes, Dimitri Vordos, …
The Journal of urology, Vol.215(5S), p.e722
05/2026
DOI: 10.1097/01.JU.0001191484.59024.a0.08

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Abstract

INTRODUCTION AND OBJECTIVES: Bladder leiomyoma (BL) is a rare, benign mesenchymal tumor representing less than 0.5% of all bladder neoplasms, with roughly 250 cases reported worldwide. Although benign, BL can significantly affect quality of life, highlighting the need for timely diagnosis and appropriate management. Its etiology and clinical behavior remain poorly understood. This multicenter retrospective study aimed to characterize BL and explore potential etiological factors. METHODS: Patients with histologically confirmed BL treated at 15 hospitals between November 1995 and October 2025 were included. Statistical analyses used Student t or Mann-Whitney U tests for continuous variables, and Chi-squared or Fisher’s exact tests for categorical data. Correlations were assessed with Spearman’s rank, and logistic regression models estimated odds ratios. RESULTS: Sixty-seven patients were included (53.7% female; mean age 58.5±2.0 years). Half (50.7%) were asymptomatic at diagnosis. Mean BMI was 26.3±0.7 kg/m2, with 47.8% overweight or obese and 65.7% meeting ≥1 metabolic syndrome criterion. Tumor size was inversely associated with vascular disorders (p=0.02), and especially hypertension (p=0.03). Transurethral bladder resection was the most common treatment (64.2%), followed by partial cystectomy (19.4%; 57.1% laparoscopic) and bladder excision (10.4%). Tumor size and location were not associated with preoperative symptoms but significantly influenced surgical management, with larger intramural tumors requiring more invasive procedures (p=0.006; p=0.02). Over a mean follow-up of 33.1 months, on 4 recurrences were reported. Symptoms at diagnosis, particularly LUTS, predicted recurrence or persistent symptoms (OR=0.52 [0.29-0.94] and 0.44 [0.26-0.76]). Notably, four patients who underwent surgery were asymptomatic at diagnosis but developed either recurrence or postoperative symptoms. CONCLUSIONS: This is the largest cohort to date describing the clinical and histological characteristic of BL. The high proportion of asymptomatic cases suggests its true incidence is likely underestimated. Although recurrence was rare, persistent LUTS were common and linked to symptomatic presentation. These findings support a multifactorial pathogenesis involving vascular and metabolic factors and highlight the need for personalized care. Further mechanistic studies are warranted to guide less invasive, targeted management strategies.

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