An Uncommon Case of Urethral Leiomyoma in a Female

Rare sites of myoma can present with unusual symptoms, which can cause clinical dilemmas in management. Leiomyomas are benign mesenchymal tumours which arise from smooth muscles. They are commonly found in the uterus. Leiomyoma in the vagina and urethra are a rare occurrence. The literature mostly reported cases of urethral leiomyoma arising from the proximal urethra. In our case, we report a distal urethral leiomyoma, which is an unusual location. This young lady was a 32-year-old Filipino (Asian) lady who presented with mass per vagina, recurrent UTI, difficulty in micturition, discharge per vagina, the feeling of fullness in the vagina, difficulty and unpleasantness during sex for 2.5 years. She came with previous medical records & USG which disclosed many differential diagnoses of PID, cystocele, urethrocele, embryological remnant cyst, urethral diverticulitis and caruncle. She was treated for her complaints, nonetheless, her symptoms gradually became more disabling. After a thorough urogynecological investigation, which included an ultrasound, MRI with contrast and biopsy of the mass, the precise diagnosis of a distal urethral benign leiomyoma’ was made. She underwent a complete surgical excision under general anaesthesia, with excellent post-operative recovery, and was well relieved of all her complaints.