1. Vaginal Myomectomy to Resolve Bladder Outlet Obstruction 50 Years After Hysterectomy
- Author
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Shorty Johansson, Kaitlyn Mayer, Rustin Walters, and Stuart H. Shippey
- Subjects
medicine.medical_specialty ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,urologic and male genital diseases ,Hysterectomy ,03 medical and health sciences ,Bladder outlet obstruction ,0302 clinical medicine ,Uterine Myomectomy ,Medicine ,Humans ,Aged ,030219 obstetrics & reproductive medicine ,Leiomyoma ,business.industry ,Urinary retention ,fungi ,food and beverages ,Obstetrics and Gynecology ,Urinary Retention ,Surgery ,Urinary Bladder Neck Obstruction ,Urinary Bladder Neoplasms ,Vagina ,Female ,Stents ,Vaginal myomectomy ,medicine.symptom ,business - Abstract
Leiomyomas can develop after hysterectomy and, when located in the bladder, can result in voiding dysfunction and incontinence.Fifty years after a hysterectomy, a 77-year-old woman presented with a 1-year history of urinary retention requiring self-catheterization and bothersome urinary incontinence. Multiple imaging modalities demonstrated a well-circumscribed 2-cm mass abutting the bladder beneath the trigone. After ureteral stent placement, we excised the nonpalpable mass using ultrasound guidance. We identified a 1.5-cm incidental cystomy and repaired it in layers. After the repair, we placed a suprapubic catheter. Pathologic examination of the mass revealed a leiomyoma. Postoperatively, we confirmed the integrity of the bladder, removed the ureteral stents, and reviewed postvoid residuals, which were minimal before removing the suprapubic catheter. Six weeks after her operation, the patient voided spontaneously with significant improvement of her urinary incontinence.Vaginal resection with ureteral stenting represents a safe surgical approach for resection of a symptomatic, benign bladder mass.
- Published
- 2018