膀胱平滑肌瘤的诊断与治疗(附21例报告并文献复习)

目的:探讨膀胱平滑肌瘤的临床特点、诊治方法及预后。方法:回顾性分析21例膀胱平滑肌瘤患者的临床资料及术后随访,并复习相关文献。结果:本组21例患者分别采用膀胱部分切除、膀胱肿瘤剜除和经尿道膀胱肿瘤电切术治疗,术后病理诊断均为膀胱平滑肌瘤,术后随访9个月～8年,均无肿瘤转移或复发。结论:膀胱平滑肌瘤系泌尿系少见的良性肿瘤。结合影像等资料能够初步诊断,确诊依靠膀胱镜检查及病理活检,治疗以手术为主,预后良好。     

膀胱平滑肌瘤误诊为子宫肌瘤1例并文献复习

目的:探讨膀胱平滑肌瘤的临床特点和诊治方法。方法:回顾性分析1例误诊为子宫肌瘤的膀胱平滑肌瘤患者的临床资料,患者女,50岁,尿频、尿急2个月余,间断无痛肉眼血尿10天。CT扫描示膀胱后壁有一2.6cm×3.1cm均质肿块突向膀胱内,界限清楚。行开放手术剜除肿瘤。结果:病理诊断为膀胱平滑肌瘤。术后患者恢复良好,排尿刺激症状消失。结论:膀胱平滑肌瘤与子宫肌瘤均为良性肿瘤,女性多发。二者均可出现膀胱刺激症状和下腹疼痛,不易鉴别。超声是较为敏感的诊断工具,而CT和MRI更有助于鉴别诊断和治疗方法的选择。两病治疗均首选手术,预后良好。     

多发性膀胱平滑肌瘤误诊为子宫内膜异位症1例并文献复习

目的提高对膀胱平滑肌瘤的认识,探讨其诊治方法。方法分析1例误诊为子宫内膜异位症的多发性膀胱平滑肌瘤患者的临床资料,并在文献复习的基础上对两种疾病的发病情况、临床表现、诊断及治疗方法进行讨论。结果患者经手术治愈,随访18个月,未见复发。结论膀胱颈部平滑肌瘤与子宫内膜异位症均可导致膀胱刺激症状和慢性盆腔痛,诊断主要依靠影像学检查,而剖宫产术导致的膀胱与宫颈粘连可造成诊断上的困难。两病治疗均首选手术,预后良好。     

经尿道剜除术治疗膀胱平滑肌瘤的疗效观察

目的：探讨经尿道膀胱肿瘤剜除术治疗膀胱平滑肌瘤的疗效。方法：2009年2月～2012年11月我院采用经尿道膀胱肿瘤剜除术的方式治疗8例膀胱平滑肌瘤患者。在电切镜下先将肿瘤完整剜除,再用电切刀逐步切除,冲洗器将标本取出。结果：8例手术均成功,手术用时30～40min,平均34min。术中及术后无周围脏器损伤、大出血、尿漏、感染等发生。术后病理回报均为膀胱平滑肌瘤。术后随访3个月～4年,均未见肿瘤转移复发。结论：采用经尿道膀胱肿瘤剜除术治疗膀胱平滑肌瘤操作简单、出血少、创伤小、术后恢复快且并发症少,是一种疗效较好的手术方式。     

经尿道等离子膀胱肿瘤剜除术治疗膀胱平滑肌瘤的临床分析

目的:探讨经尿道等离子膀胱肿瘤剜除术治疗膀胱平滑肌瘤的临床疗效。方法:回顾性分析2012年12月—2022年12月济宁市第一人民院治疗的6例膀胱平滑肌瘤患者的临床资料,所有患者均采用经尿道等离子膀胱肿瘤剜除术完整剜除肿瘤,再将组织切成小块冲出。结果:6例患者平均手术时间30 min,术后无出血、穿孔、感染等并发症,术后病理诊断为膀胱平滑肌瘤,均顺利康复出院。术后随访1～3年未见复发。结论:经尿道等离子膀胱肿瘤剜除术治疗膀胱平滑肌瘤创伤小、恢复快,是治疗膀胱良性肿瘤安全可靠的手术方式。     

膀胱平滑肌瘤的诊断和治疗(附11例报告)

目的：探讨膀胱平滑肌瘤的临床表现、诊治方法和预后情况。方法：对11例膀胱平滑肌瘤患者分别采用肿瘤剜除、膀胱部分切除或经尿道膀胱肿瘤电切术治疗。结果：术后随访6个月～10年，10例生存良好，未发现肿瘤复发或转移；1例术后3年出现膀胱移行细胞癌。结论：膀胱平滑肌瘤是一种少见的良性肿瘤，预后良好。B超是首选筛查手段，确诊需行膀胱镜检查及病理活检。外科开放手术是其主要的治疗方法。     

膀胱平滑肌瘤2例报告并文献复习21例

目的:探讨膀胱平滑肌瘤的临床表现、诊治方法和预后.方法;结合21例膀胱平滑肌瘸患者文献资料,其中男性4例,女性17例,年龄20-65岁,平均40岁,21例B起检查发现膀脆占位病变,CT检查发现肿物有不同程度强化.21例分别采取肿次捌除术、经尿道肿物切除术、膀胱部分切除术,术后病理均田报为膀胱平滑肌瘤.结果,21例患者排尿刺激症状缓解、血尿消失.未发生手术并发症.术后随访6月-5年,未见肿瘤复发或转移.结论:影像学结合膀胱镜是诊断膀胱平滑肌瘤的主要手段,外科手术治疗预后良好.     

腹腔镜膀胱部分切除术治疗膀胱平滑肌瘤4例报告及文献复习

目的:探讨腹腔镜膀胱部分切除术治疗膀胱平滑肌瘤的可行性及治疗效果。方法:2008年1月至2014年11月为4例诊断为膀胱平滑肌瘤的患者行腹腔镜膀胱部分切除术。回顾分析患者的临床资料,包括年龄、性别、症状、肿瘤大小与位置、围手术期资料、术后随访资料等。结果:4例手术均顺利完成。中位肿瘤直径2.4 cm(2.0~3.2 cm);中位手术时间105 min(95~120 min);中位术中预计出血量80 ml(60~110 ml);中位术后住院时间7 d(5~8 d);术后1例出现短暂发热;中位术后随访43.5个月(3~70个月),未见肿瘤复发。结论:膀胱平滑肌瘤临床少见,属于良性肿瘤,具备手术适应证的患者可行腹腔镜膀胱部分切除术,手术安全、可靠,效果良好。     

十二指肠平滑肌肿瘤的诊断及治疗

目的：探讨十二指肠平滑肌瘤的诊断及治疗方法。方法：回顾性分析1987年至2001年手术切除并经病理证实的7例十二指肠平滑肌肿瘤。结果：十二指肠平滑肌瘤4例、平滑肌肉瘤3例。本病缺乏典型症状，早期诊断困难。本组病人均行手术治疗，取得良好疗效。结论：上消化道出血是本病常见的症状，上消化道造影、胃十二指肠镜及CT扫描是主要的诊断方法。外科手术是首选的治疗方法。     

膀胱平滑肌瘤的诊疗分析

目的:探讨膀胱平滑肌瘤的病因、临床表现、诊治方法和预后。方法:回顾性分析我院2002年~2014年诊断为膀胱平滑肌瘤的6例患者临床资料:男2例,女4例,平均年龄56岁。排尿刺激症状1例,排尿障碍2例,血尿2例,无症状1例。术前均行CT、B超检查及膀胱镜检查,肿瘤直径为1.2~5.6cm,平均3.2cm。6例均采用手术治疗(1例行膀胱部分切除术,5例行经尿道膀胱肿瘤剜除术),术后基底部取活检。结果:术后患者均无血尿,排尿障碍及排尿刺激症状均明显改善,术后随访3个月~6年,平均4.2年,膀胱镜、B超或CT检查无肿瘤复发或转移。结论:膀胱平滑肌瘤常表现为排尿障碍、排尿刺激症状、血尿或腹痛等症状,也可无明显临床表现。诊断主要依靠B超、CT和膀胱镜检查,初诊时误诊率较高;外科手术是其主要的治疗方法,可采用膀胱部分切除术、经尿道膀胱肿瘤剜除术或经尿道膀胱肿瘤电切术,预后良好。     

膀胱平滑肌瘤:附8例报告

目的 探讨膀胱平滑肌瘤的临床特点及诊治疗效.方法 对8例膀胱平滑肌瘤患者的临床资料进行回顾性分析.结果 8例患者,男性3例,女性5例,平均年龄42岁(27岁～71岁).经尿道膀胱肿瘤电切(TURBT)3例,开放膀胱部分切除术2例,肿瘤剜除2例,腹腔镜膀胱肿瘤剜除1例.8例患者随访10～75个月未见肿瘤复发.结论 膀胱平滑肌瘤临床罕见,手术效果满意,手术方式的选择应根据肿瘤大小和位置决定,腹腔镜手术创伤小、恢复快,将成为一种有效的手术替代方式.     

壁间型膀胱平滑肌瘤十例患者诊治经验的初步探讨

目的通过对壁间型膀胱平滑肌瘤的诊疗进行回顾性分析,初步探讨其临床诊疗方式。方法回顾性分析2010年1月至2019年1月于徐州医科大学附属医院泌尿外科行手术治疗壁间型膀胱平滑肌瘤10例患者资料。其中男性1例,女性9例,年龄33~51(44±6)岁。其中5例患者以膀胱刺激症状为主要临床表现,1例患者以下腹痛为主要表现,还有4例患者无明显临床症状,患者发病时间1周至2年,平均4.9个月。患者泌尿系彩超检查发现膀胱壁上形态规则、表面覆盖黏膜高回声的低回声包块。CTU检查为膀胱壁均质样实性肿块,边界清楚、光滑,无侵蚀表现,膀胱壁走形自然,且壁周脂肪间隙清晰,膀胱内可见充盈缺损。膀胱镜检查可见瘤体表面黏膜常完整连续,可见局部稍向膀胱内隆起。根据患者肿瘤部位、大小,10例患者分别采用经尿道平滑肌瘤剜除术和腹腔镜下平滑肌瘤剜除术,3例患者术中冰冻切片示:膀胱平滑肌瘤。结果10例患者中有临床症状者:其中5例以膀胱刺激症状为主诉的患者术后症状明显缓解,表现为下腹部疼痛症状的患者术后腹痛症状消失,所有患者术后均未发生并发症,术后随访4~24个月(平均16个月)均未见肿瘤复发且未诉漏尿等常见并发症。结论泌尿系彩超,CTU等影像学检查与膀胱镜相结合是诊断壁间型膀胱平滑肌瘤的主要手段,经尿道肿瘤剜除术、腹腔镜下肿瘤剜除术是治疗壁间型膀胱平滑肌瘤安全有效的手术方式且预后较好。     

Fistula between degenerated uterine leiomyoma and the bladder: case report

Most common reason for the vesicouterine fistula is a cesarean section; no cases were reported of degenerated uterine leiomyoma communicating with the urinary bladder. We report a case of fistulous communication between the degenerated leiomyoma and the bladder. The patient's initial clinical presentation was consistent with recurrent UTI. She underwent multiple examinations including cystoscopy, cystouretrography, retrograde pyeolography, and MRI. The ultimate treatment was an exploratory laparotomy and en-block resection of the bladder wall, fistula tract, and degenerated leiomyoma. Fistula can develop between the bladder and degenerated leiomyoma and could be one of the reasons for the chronic pelvic pain and dysuria.     

Leiomyomas of the female urethra and bladder: a report of five cases and review of the literature

Through the experience of five cases of leiomyoma developed in the female bladder and urethra with a review of the literature, we have made an effort to characterize the association of symptom with the size and location of the tumor and demonstrate an appropriate treatment. The study population was composed of patients who underwent surgery for bladder or urethral leiomyoma in our hospital from March 1990 to April 2005. Their medical records were reviewed retrospectively concerning the symptom, size and location of leiomyoma, the result of cystoscope and radiological examination, surgical method, pathologic report, complications, and recurrence. Four cases were diagnosed as urethral leiomyoma and one case as bladder leiomyoma. All patients with urethral leiomyoma were admitted for the chief complaint of a palpable tumor. When the tumor size was small, if it was located on the lateral side of the urethra, it was asymptomatic, but if located in the midline, it presented irritative or obstructive symptom. When it was big, if located on the lateral side, it presented irritative rather than obstructive symptom, and if located in the midline, it presented obstructive symptom. One case of bladder leiomyoma was discovered incidentally during ultrasonic exam. In all five cases, surgical removal was performed and complications or recurrence were not detected afterwards. Bladder and urethral leiomyomas are very rare and cause diverse manifestations from asymptomatic to irritative or obstructive symptom. It is presumed that the location and size of the tumor are associated with symptom. Unless it is the case with severe hemorrhage or obstructive acute renal failure, immediate surgery is not required. However, it is desirable to distinguish leiomyoma from malignant or other benign tumors by surgical biopsy or removal.     

Leiomioma vesical

ObjectiveMesenchymal benign tumours of the urinary bladder are rare and account for 1%-5% of all bladder tumours. The leiomyoma is the most common and constitute 46.6% of this group. 25 cases have been described in the national literature. We report an additional case of leiomyoma of the bladderCase ReportA 53 year-old man with a chronic history of urinary frequency and microscopic hematuria. Physical examination was normal. An excretory urography demonstrated a filling defect in the right bladder wall. The cistoscopy confirmed the tumour, covered with normal bladder mucosa. The echography showed a solid tumour. A computerised tomography scan and magnetic resonance showed a sessile lesion in the right bladder wall with low-intermediate intensity signal and with normal signal of muscle, mucosa and perivesical fat. The clinical diagnosis was leiomyoma of the bladder. Partial cystectomy was done and the histological diagnosis confirmed the clinical diagnosisConclusionsThe leiomyoma of the bladder is a rare tumour however it should be considered in the differential diagnosis before surgical treatment     

Leiomyoma of the bladder. Case report.

A 33-year-old woman was incidentally noted to have a benign bladder leiomyoma on pelvic ultrasonography during pregnancy. This was resected and she made an uneventful recovery. Leiomyomas of the bladder are rare and usually asymptomatic; the treatment is excision.     

Male bladder leiomyoma: a case report]

A case of leiomyoma of the urinary bladder in a 40-year-old man is reported. Enucleation of the tumor was performed, because transurethral resection-biopsy revealed a bladder leiomyoma. Ninety nine cases of a bladder leiomyoma have been reported in Japan, but male cases are rare.