Leiomyoma of the Urethra

Urethral leiomyomas are rare (Fig. 45). They present as masses in the vaginal wall, or protruding through the urethral meatus (86). Pathogenesis is uncertain; however they are felt to be ER dependent (87,88). Malignant transformation has not been reported. Histologically, they are composed of interlacing bundles of benign smooth muscle cells (Table 45).

Table 43 Skene's Duct Cyst

Diagnosis

Symptoms

Clinical appearance

Differential diagnosis

Therapy

Skene's Mass, dysuria, duct urinary cyst spraying, pain, discharge, dyspareunia

Cystic mass Urethral diverticulum, prolapsed Excision, ectopic ureterocele, cystocele, marsupia-urethrocele, Gartner's lization,

(Wolffian) or Mullerian needle duct cyst aspiration

Table 44 Suburethral Diverticulum

Diagnosis Symptoms Clinical appearance Differential diagnosis Therapy

Urethral Recurrent urinary Anterior vaginal wall Ectopic ureterocele, Surgical diverticulum tract infection, suburethral mass, paraurethral cyst, incontinence, which may drain Gartner's duct cyst, postvoid purulent or bloody inclusion cyst, dribbling fluid, or urine (81) urethral carcinoma

(A) (B)
Vaginal Leiomyosarcoma Symptoms
Figure 46 Urethral carcinoma. (A) Tumor mass protruding through urethra. (B) Infiltrating transitional cell carcinoma.
Table 45 Leiomyoma of the Urethra

Diagnosis

Symptoms

Clinical appearance

Differential diagnosis

Therapy

Urethral

Dysuria, difficulty voiding,

Urethral

Urethral

Surgical

leiomyoma

urinary tract infection,

mass

caruncle

hematuria

Symptoms appearance Differential diagnosis Therapy

Diagnosis

Urethral Obstruction, hematuria, carcinoma vaginal/urethral bleeding, urinary tract infection, dysuria, frequency, incontinence

Mass Caruncle, condyloma, Surgery, urethral polyp, possible urethral prolapse radiation

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