膀胱平滑肌瘤15例临床分析

目的探讨膀胱平滑肌瘤的临床表现、诊治方法和预后。方法回顾性分析1997年1月～2008年5月收治的15例膀胱平滑肌瘤患者的资料。其中男4例，女11例，年龄28~65岁，平均35岁。临床表现为排尿梗阻6例，排尿刺激症状5例，肉眼血尿3例，无任何临床症状体检时发现1例。病程1个月～3年，平均11．5个月。15例B超检查发现膀胱内占位病变，CT检查发现肿物均有不同程度强化，IVU检查12例发现膀胱充盈缺损，膀胱镜检查11例提示黏膜下占位。15例术前病理活检2例报告为平滑肌瘤。15例分别采用肿瘤剜除、膀胱部分切除和经尿道膀胱肿瘤电切术治疗。13例行术中冰冻切片检查，报告为平滑肌瘤。结果15例患者术后排尿通畅，排尿刺激症状明显缓解，血尿消失。未发生手术并发症。术后随访6个月～5年，平均3年，未见肿瘤复发或转移。结论影像学结合膀胱镜检查是诊断膀胱平滑肌瘤的主要手段，外科手术治疗预后良好。

Clinical analysis of 15 cases with bladder leiomyoma

Objective To discuss the clinical symptoms, diagnosic methods, most commomly used treatment, and prognosis of bladder leiomyoma. Methods The clinical data of 15 patients （4 male, 11 femal） with bladder leiomyoma were analyzed retrospectively. The mean age was 35 years （range 28-65）. Clinical manifestation included dysuresia in 6 cases, irritative bladder in 5, gross hematuria in 3 and absence of symptoms in 1. The mean course was 11.5 months （range 1 month -3 years）. 15 bladder tumors were indicated from B ultrasonography and CT scan. 12 filling defects were showed on intravenous urogram. 11 tumors under mucosa were found by cystoscopy. Of the 15 cases, leiomyoma was only confirmed in 2 cases by biopsy. All patients were treated with enucleation, partial cystectomy or transurethral resection respectively. Leiomyoma was confirmed by frozen sections during operation in 13 cases. Results 15 patients regained normal urination, their irritation was relieved obviously, and hematuria disappeared. No complications occured. Recurrence and metastases could not be found during follow-up of 6 months to 5 years. Oonclusion Bladder leiomyoma is an unusual benign tumor. Imaging and cystoscopy are the most important diagnostic methods. Preoperative biopsy or frozen sections during operation should be conducted. Operation offers excellent results.