Department of Urology, The First Hospital of Jilin University, Changchun, Jilin, China.
Medicine (Baltimore). 2024 Nov 1;103(44):e40340. doi: 10.1097/MD.0000000000040340.
Prostate leiomyoma is a rare condition globally, often challenging to diagnose preoperatively, with most cases being definitively identified through postoperative pathology. This benign tumor generally has a good prognosis and is primarily treated with transurethral resection of the prostate in clinical settings. However, there are no established guidelines or therapeutic protocols for managing this disease.
The patient was admitted to our hospital's Department of Urology with complaints of hematuria, urinary frequency, and urgency for 1 month. Pelvic computed tomography revealed an irregular, mass-like high-density shadow posterior to the bladder, indistinctly separated from the prostate. The patient had been diagnosed with renal insufficiency during a physical examination 4 years prior but had not received standardized treatment. Six years ago, the patient underwent electrocision of the prostate at our hospital, and postoperative pathology indicated prostate leiomyoma.
Postoperative pathology confirmed a diagnosis of prostate leiomyoma.
The patient presented with an enlarged prostate and preoperative hematuria. Holmium laser enucleation of the prostate (HoLEP) was performed. The Foley catheter was removed on the second postoperative day, and the patient was discharged 3 days after surgery.
Following discharge, the patient was instructed to undergo reexaminations every 6 months. Current follow-up indicates the patient is in good health, with no recurrence of the mass observed.
Prostate leiomyoma is an extremely rare condition, and the current primary approach for managing prostate smooth muscle tumors involves active patient monitoring, regular evaluations, and timely surgical intervention if clinical symptoms emerge. In this study, we present a new case report of prostatic smooth muscle tumor and review the existing literature to explore treatment options for prostate leiomyoma within this field.
前列腺平滑肌瘤在全球范围内较为罕见，术前诊断颇具挑战性，大多数病例通过术后病理明确诊断。这种良性肿瘤通常预后良好，临床主要通过经尿道前列腺切除术进行治疗。然而，目前尚无针对该疾病的既定指南或治疗方案。
患者因血尿、尿频和尿急症状 1 个月入住我院泌尿科。盆腔 CT 显示膀胱后不规则块状高密度影，与前列腺分界不清。患者 4 年前体检时被诊断为肾功能不全，但未接受规范治疗。6 年前，患者曾在我院行前列腺电切术，术后病理提示前列腺平滑肌瘤。
术后病理证实为前列腺平滑肌瘤。
患者前列腺增大，术前存在血尿。行钬激光前列腺剜除术（HoLEP）。术后第 2 天拔除 Foley 导管，术后 3 天出院。
出院后，嘱患者每 6 个月复查。目前随访提示患者健康状况良好，未观察到肿块复发。
前列腺平滑肌瘤极为罕见，目前管理前列腺平滑肌肿瘤的主要方法是积极监测患者、定期评估，如果出现临床症状则及时进行手术干预。本研究报告了前列腺平滑肌肿瘤的 1 例新病例，并回顾了现有文献，以探讨该领域前列腺平滑肌瘤的治疗选择。
