Transvaginal partial excision of a circumferential urethral leiomyoma: Surgical technique and outcome

Leanne Brechtel; Joanna Orzel; Yiqin Xiong; Annah Vollstedt

doi:10.1016/j.eucr.2025.103049

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Transvaginal partial excision of a circumferential urethral leiomyoma: Surgical technique and outcome

Journal article

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Transvaginal partial excision of a circumferential urethral leiomyoma: Surgical technique and outcome

Leanne Brechtel, Joanna Orzel, Yiqin Xiong and Annah Vollstedt

Urology case reports, Vol.61, 103049

07/2025

DOI: 10.1016/j.eucr.2025.103049

PMCID: PMC12432835

PMID: 40950797

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Abstract

We present a rare case of a 68-year-old female with urinary retention and a peri-urethral mass. The patient, with a history of thoracic aortic aneurysm, was referred to urology after a urethral mass was incidentally detected on CT imaging during aneurysm surveillance. Pelvic MRI identified a 4.8 cm circumferential, enhancing mass along the proximal urethra. A transvaginal ultrasound-guided biopsy confirmed a low-grade smooth muscle neoplasm, consistent with leiomyoma. The mass was successfully excised via a transvaginal approach. This case highlights the importance of a broad differential in female urinary retention and demonstrates the feasibility of vaginal excision for peri-urethral masses. •We describe a rare case of circumferential urethral leiomyoma causing chronic urinary retention.•The mass was stable for years but contributed to long-term catheterization difficulty.•Transvaginal partial excision improved symptoms while minimizing surgical morbidity.•First report describing vaginal excision of a circumferential urethral leiomyoma.•MRI and biopsy were key in diagnosis, guiding a targeted surgical approach.

Urethral mass

Urinary retention

Voiding dysfunction

Details

Title: Subtitle: Transvaginal partial excision of a circumferential urethral leiomyoma: Surgical technique and outcome
Creators: Leanne Brechtel - University of Iowa Health Care, Department of Urology, 200 Hawkins Drive, Iowa City, IA, 52242, United States
Joanna Orzel - University of Iowa
Yiqin Xiong - University of Iowa Healthcare, Department of Pathology, United States
Annah Vollstedt - University of Iowa
Resource Type: Journal article
Publication Details: Urology case reports, Vol.61, 103049
DOI: 10.1016/j.eucr.2025.103049
PMID: 40950797
PMCID: PMC12432835
NLM abbreviation: Urol Case Rep
ISSN: 2214-4420
eISSN: 2214-4420
Publisher: Elsevier Inc
Language: English
Date published: 07/2025
Academic Unit: Urology
Record Identifier: 9984821352702771

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