Characteristics and Outcomes in Bladder Leiomyoma Management: A Systematic Review of Case Reports and Case Series from the Past 20 Years

Abstract

Introduction Less than 0.5% of cases are bladder leiomyomas, which are uncommon, non-cancerous growths that originate from the smooth muscle cells of the bladder. The purpose of this review is to compile existing data and present a summary of bladder leiomyomas' characteristics, management, and related outcomes. Method Case studies or series describing individuals with bladder leiomyoma who underwent surgery and the results they reported thereafter were included. Four databases were used in our literature search, which was carried out until January 2024: PubMed, Proquest, EBSCOHost, and Google Scholar. We utilized MeSH terms such "leiomyoma," "urinary bladder," and looked for synonyms of "bladder leiomyoma" in free text. Results The majority of reported bladder leiomyoma cases were in female accounting for 77.7% of all cases. While symptomatic patients primarily presented with lower urinary tract symptoms (LUTS) (60.7%), hematuria (23.0%), acute urine retention (11.5%), and about 16.4% of cases were incidentally detected. Storage-related symptoms were the most common LUTS (32.8%). Different diagnostic techniques were used, frequently combining CT, MRI, USG, and/or cystoscopy. Bladder leiomyomas were commonly found on left lateral wall (26.4%) and the bladder neck (17.4%). In more than half of the cases (51.2%) the treatment techniques used were transurethral resection (TURBt/TUR). Fifteen out of 121 cases had recurrence or remain symptomatic. Conclusion Further investigation is necessary to fully understand the best course of treatment and long-term results for bladder leiomyomas. In particular, prospective trials with bigger participant pools and meticulously controlled factors should be the main emphasis of this research.