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Management of bladder neck leiomyoma during pregnancy.

Tupikowski K, Szewczyk P, Szydełko T, Hałoń A, Polok M, Dembowski J, Zdrojowy R - Cent European J Urol (2011)

Bottom Line: Subsequent to a cesarean section, a successful transurethral resection was performed.Here the diagnostic complexity in the pregnant patient, clinical course, and outcome are described.One year after successful treatment both mother and daughter are in good condition.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology and Oncological Urology, Wrocław, Medical University, Wrocław, Poland.

ABSTRACT
A 29-year-old primigravida was admitted to the urology ward with acute urinary retention. The patient underwent cystoscopy, MRI (magnetic resonance imaging), and tissue biopsy, which consequently led to the diagnosis of bladder neck leiomyoma that obstructed urine outflow. Subsequent to a cesarean section, a successful transurethral resection was performed. Here the diagnostic complexity in the pregnant patient, clinical course, and outcome are described. One year after successful treatment both mother and daughter are in good condition.

No MeSH data available.


Related in: MedlinePlus

T2-weighted MRI image of bladder tumor (arrow), A – axial and B – sagittal planes; the pedicle invades the bladder neck without crossing its whole thickness. The Foley catheter (double arrow) and fetus (triple arrow) can also be seen.
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Figure 0002: T2-weighted MRI image of bladder tumor (arrow), A – axial and B – sagittal planes; the pedicle invades the bladder neck without crossing its whole thickness. The Foley catheter (double arrow) and fetus (triple arrow) can also be seen.

Mentions: A 29-year-old primigravida, 18-weeks pregnant, was experiencing urinary retention. The first voiding difficulties appeared in the 9th gestational week. There were no urological complaints before pregnancy. Ultrasonography (USG) of the bladder neck revealed a well circumscribed, 4.5-centimeter exophytic lesion with rich flow in Doppler mode. The patient was catheterized then a cystoscopy (Fig. 1a) and MRI (Fig. 2a,b) followed. Biochemical investigations did not reveal any significant abnormalities. Neoplastic markers, CA125, CA19-9, CA15.3, and AFP, were within normal ranges. The specimen from the transvaginal biopsy revealed smooth muscle tissue indicating a bladder neck leiomyoma. In the 36th week, a healthy girl was delivered via c-section. Some weeks later, during the transurethral resection (TUR), after resecting the main body of the leiomyoma a superficial cut (less than the resectoscope's loop depth) into the neck was performed to excise as much of the leiomyoma's pedicle as possible without damaging the sphincter (Fig. 1b). Postoperative histopathology confirmed the preoperational diagnosis. Subsequently, the patient voided without difficulties and had no urine leakage. Cystoscopy (Fig. 1c) and MRI showed no regrowth after six months. One year after cesarean delivery and simultaneous excision of two small uterine leiomyomas both mother and daughter are well.


Management of bladder neck leiomyoma during pregnancy.

Tupikowski K, Szewczyk P, Szydełko T, Hałoń A, Polok M, Dembowski J, Zdrojowy R - Cent European J Urol (2011)

T2-weighted MRI image of bladder tumor (arrow), A – axial and B – sagittal planes; the pedicle invades the bladder neck without crossing its whole thickness. The Foley catheter (double arrow) and fetus (triple arrow) can also be seen.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3921743&req=5

Figure 0002: T2-weighted MRI image of bladder tumor (arrow), A – axial and B – sagittal planes; the pedicle invades the bladder neck without crossing its whole thickness. The Foley catheter (double arrow) and fetus (triple arrow) can also be seen.
Mentions: A 29-year-old primigravida, 18-weeks pregnant, was experiencing urinary retention. The first voiding difficulties appeared in the 9th gestational week. There were no urological complaints before pregnancy. Ultrasonography (USG) of the bladder neck revealed a well circumscribed, 4.5-centimeter exophytic lesion with rich flow in Doppler mode. The patient was catheterized then a cystoscopy (Fig. 1a) and MRI (Fig. 2a,b) followed. Biochemical investigations did not reveal any significant abnormalities. Neoplastic markers, CA125, CA19-9, CA15.3, and AFP, were within normal ranges. The specimen from the transvaginal biopsy revealed smooth muscle tissue indicating a bladder neck leiomyoma. In the 36th week, a healthy girl was delivered via c-section. Some weeks later, during the transurethral resection (TUR), after resecting the main body of the leiomyoma a superficial cut (less than the resectoscope's loop depth) into the neck was performed to excise as much of the leiomyoma's pedicle as possible without damaging the sphincter (Fig. 1b). Postoperative histopathology confirmed the preoperational diagnosis. Subsequently, the patient voided without difficulties and had no urine leakage. Cystoscopy (Fig. 1c) and MRI showed no regrowth after six months. One year after cesarean delivery and simultaneous excision of two small uterine leiomyomas both mother and daughter are well.

Bottom Line: Subsequent to a cesarean section, a successful transurethral resection was performed.Here the diagnostic complexity in the pregnant patient, clinical course, and outcome are described.One year after successful treatment both mother and daughter are in good condition.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology and Oncological Urology, Wrocław, Medical University, Wrocław, Poland.

ABSTRACT
A 29-year-old primigravida was admitted to the urology ward with acute urinary retention. The patient underwent cystoscopy, MRI (magnetic resonance imaging), and tissue biopsy, which consequently led to the diagnosis of bladder neck leiomyoma that obstructed urine outflow. Subsequent to a cesarean section, a successful transurethral resection was performed. Here the diagnostic complexity in the pregnant patient, clinical course, and outcome are described. One year after successful treatment both mother and daughter are in good condition.

No MeSH data available.


Related in: MedlinePlus