Silva-Ramos M, Massó P, Versos R, Soares J, Pimenta A
Serviço de Urologia, Hospital Geral de Santo António, Porto, Portugal.
Actas Urol Esp. 2003 Sep;27(8):581-6. doi: 10.1016/s0210-4806(03)72979-9.
Bladder leiomyomas (BL) are rare. Most publications regarding these tumours are reports of isolated cases; therefore they don't allow an evaluation of diagnostic and treatment procedures.
MATERIAL & METHODS: We preformed a pooled analysis of 90 cases of BL reported in the literature.
Mean age was 45.3 (19 to 85 years), 68 (75.6%) were women. Filling symptoms were the most frequently reported (50%), followed by voiding symptoms (24.4%). Twenty four patients (26.7%) were asymptomatic. Tumours were endoluminal in 46 patients (51.1%), intramural in 27 (30%) and extravesical in 15 (16.7%). A laparotomy was performed in 56 patients (62.2%), with enucleation in 29 (32.2%), partial cystectomy in 25 (27.8%) and total cystectomy in 2 (2.2%). A transurethral resection was preformed in 27 (30%) and a transvaginal resection in 5 (5.6%). Two patients underwent conservative treatment. In 3 cases there were reports of recurrence and one patient got a vesicovaginal fistula.
Although BL are rare, when evaluating bladder tumours, imaging techniques can make suspect of this neoplasm. Surgical treatment of these tumours has a very high success rate. Usually an enucleation or a transurethral resection is sufficient to render the patient tumour free, avoiding a more iatrogenic surgery.
膀胱平滑肌瘤（BL）较为罕见。大多数关于这些肿瘤的出版物都是孤立病例报告；因此，它们无法对诊断和治疗程序进行评估。
我们对文献中报道的90例膀胱平滑肌瘤进行了汇总分析。
平均年龄为45.3岁（19至85岁），68例（75.6%）为女性。充盈症状是最常报告的症状（50%），其次是排尿症状（24.4%）。24例患者（26.7%）无症状。46例患者（51.1%）的肿瘤位于腔内，27例（30%）位于壁内，15例（16.7%）位于膀胱外。56例患者（62.2%）接受了剖腹手术，其中29例（32.2%）进行了摘除术，25例（27.8%）进行了部分膀胱切除术，2例（2.2%）进行了全膀胱切除术。27例（30%）进行了经尿道切除术，5例（5.6%）进行了经阴道切除术。2例患者接受了保守治疗。有3例报告复发，1例患者出现膀胱阴道瘘。
尽管膀胱平滑肌瘤罕见，但在评估膀胱肿瘤时，影像学技术可怀疑这种肿瘤。这些肿瘤的手术治疗成功率非常高。通常，摘除术或经尿道切除术足以使患者无肿瘤，避免更具医源性的手术。
