Color Doppler Imaging and 3-Dimensional Sonographic Findings of Urinary Bladder Leiomyoma

Leiomyomas of the genitourinary tract may originate from the renal pelvis, bladder, urethra, or epididymis. 1 Interestingly, leiomyomas of the bladder are more common among women (76% of cases).2 Development is usually endovesical (63%), yet extravesical (30%) and intramural cases are not rare.3 Patients may be asymptomatic or may have obstructive urinary symptoms, irritative symptoms, hematuria, flank pain, or, rarely, dysmenorrhea or dyspareunia. 2-5 Leiomyomas of the bladder have been reported in association with neurofibromatosis type 1, in which leiomyomas occur most often in the gastrointestinal tract (proximal small bowel) and tend to be multiple.6 Rarely, urinary bladder leiomyomas have been diagnosed during pregnancy 7,8 and in a woman with a previous hysterectomy. 9 Diagnostic imaging modalities used include both transabdominal and transvaginal sonography, computed tomography, and magnetic resonance imaging.10-12 Although asymptomatic, nonobstructive, and nonproblematic leiomyomas may be managed expectantly, treatment is surgical by a transurethral approach, laparoscopy, or laparotomy 1-4 We present color Doppler imaging and 3-dimensional sonographic findings of a woman with a urinary bladder leiomyoma.