Department of Urology, Qilu Hospital, Shandong University, Jinan, Shandong 250012, China.
Chin Med J (Engl). 2012 Jul;125(14):2436-9.
Bladder leiomyoma is an uncommon type of bladder neoplasms. Most publications are reports of isolated cases. The influence of tumor size on patients' early symptoms was seldom analyzed. We aim to investigate the clinical characteristics of bladder leiomyoma and the influence of tumor size on patients'symptoms in Chinese population.
We reviewed the medical records of eight patients diagnosed with bladder leiomyoma at our department, collected 53 cases from Chinese National Knowledge Infrastructure (CNKI), Wangfang data base, and Chinese Biological Medicine Disk, and performed a pooled analysis. The clinical characteristics of the patients were analyzed and then classified into symptomatic and asymptomatic groups. The association between tumor size and the occurrence of symptoms was evaluated. Furthermore, Logistic regression model was constructed to discriminate variables.
Women comprised the majority of the patients (49/61, 80.3%). The mean age and tumor size were (42.3 ± 14.0) years and (45.0 ± 25.7) mm, respectively. Among all the symptoms, irritative symptoms occurred most frequently (37.7%, 23/61), followed by obstructive urinary symptoms (31.1%, 19/61), hematuria (24.6%, 15/61), and abdominal bulge or pain (14.8%, 9/61). In our study, patients who were 45 years old or younger tended to be asymptomatic compared with elder ones (14/36 vs. 3/25, P = 0.021). The histological, as well as anatomical, location of tumor, did not show significant differences between symptomatic and asymptomatic patients (P = 0.306 and 0.700). Tumors larger than 30 mm in the greatest diameter would cause clinical symptoms such as obstructive urinary symptoms (P = 0.048) and irritative symptoms (P = 0.037). Logistic regression confirmed the association between tumor size and the occurrence of symptoms, which was related with age.
Bladder leiomyoma occurs mainly in women and most frequently with irritative symptoms. The occurrence of symptoms is related to tumor size rather than the location. In this setting, patients with endovesical tumors smaller than 30 mm in the greatest diameter tended to be asymptomatic, which were usually treated with transurethral resection of bladder tumor.
膀胱平滑肌瘤是一种罕见的膀胱肿瘤类型。大多数出版物都是孤立病例的报告。肿瘤大小对患者早期症状的影响很少被分析。我们旨在研究中国人群中膀胱平滑肌瘤的临床特征以及肿瘤大小对患者症状的影响。
我们回顾了在我科诊断为膀胱平滑肌瘤的 8 例患者的病历，从中国国家知识基础设施（CNKI）、万方数据库和中国生物医学文献光盘中收集了 53 例病例，并进行了汇总分析。分析患者的临床特征，并将其分为有症状组和无症状组。评估肿瘤大小与症状发生的关系。此外，构建了 Logistic 回归模型来区分变量。
女性占多数（49/61，80.3%）。平均年龄和肿瘤大小分别为（42.3 ± 14.0）岁和（45.0 ± 25.7）mm。所有症状中，刺激性症状最常见（37.7%，23/61），其次是梗阻性尿症状（31.1%，19/61）、血尿（24.6%，15/61）和腹部膨隆或疼痛（14.8%，9/61）。在我们的研究中，45 岁及以下的患者倾向于无症状，而年龄较大的患者则有症状（14/36 与 3/25，P=0.021）。有症状和无症状患者的肿瘤组织学和解剖学位置无显著差异（P=0.306 和 0.700）。最大直径大于 30mm 的肿瘤会引起梗阻性尿症状（P=0.048）和刺激性症状（P=0.037）等临床症状。Logistic 回归证实了肿瘤大小与症状发生之间的关联，与年龄有关。
膀胱平滑肌瘤主要发生在女性，最常见的症状是刺激性症状。症状的发生与肿瘤大小有关，而与位置无关。在这种情况下，最大直径小于 30mm 的腔内肿瘤患者倾向于无症状，通常采用经尿道膀胱肿瘤切除术治疗。
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