Urological complications of uterine leiomyoma: a review of literature

Abstract

Leiomyoma is a common tumor of the uterus that often clinically impacts on the lower urinary tract and results in urological and sexual symptoms. Leiomyoma can compress and grow into and become adherent to the bladder and surrounding pelvic organs or metastasize into peritoneal organs. Leiomyoma can enlarge and compress the urinary bladder, urethra, and lower end of the ureters. Leiomyoma can cause embarrassing sexual dysfunction in females. Current literature of non-surgical and surgical therapy of leiomyoma is described.

The Effect of Uterine Fibroids on Infertility: A Systematic Review

“…57 Women may have embarrassment secondary to mass effect on the urinary system leading to frequency or incontinence. 9 While this may not have an effect on assisted reproductive technology (ART) success, it may contribute to decreased episodes of sexual intercourse and fewer opportunities for natural conception.…”

Association of uterine leiomyoma and overactive bladder syndrome

“…Thus, the present findings suggest that there is an association between the presence of anterior/uterine leiomyoma and overactive bladder syndrome. The findings are most probably explained by the anatomic proximity of the uterus to the urinary bladder such that the uterine leiomyoma compress the urinary bladder wall and trigger symptoms of urinary urgency and/or frequency …”

“…The findings are most probably explained by the anatomic proximity of the uterus to the urinary bladder such that the uterine leiomyoma compress the urinary bladder wall and trigger symptoms of urinary urgency and/ or frequency. [7][8][9] It has been speculated that the volume of the uterus and/or total volume of leiomyoma, as well as the location, has an impact on the development of LUTS. 10 The present study did not find a correlation between the volume of uterine leiomyoma and the ICIQ-OAB sum score, although there was an association between the presence of anterior/fundal leiomyoma and OAB.…”

“…The causes of non‐neurogenic OAB are unknown, although neuronal, myogenic, and inflammatory factors are likely to be involved in its development . In addition, uterine leiomyoma may be associated with lower urinary tract symptoms (LUTS) owing to the close anatomic relationship between, specifically, anterior and/or fundal leiomyoma (hereafter anterior/fundal leiomyoma) and the urinary bladder . In a recent study of the prevalence of LUTS among women undergoing surgery for uterine leiomyoma, the mean voiding subscale score was higher for women with anterior fibroids than for women with fibroids in other locations…”

“…5,6 In addition, uterine leiomyoma may be associated with lower urinary tract symptoms (LUTS) owing to the close anatomic relationship between, specifically, anterior and/or fundal leiomyoma (hereafter anterior/fundal leiomyoma) and the urinary bladder. [7][8][9] In a recent study of the prevalence of LUTS among women undergoing surgery for uterine leiomyoma, the mean voiding subscale score was higher for women with anterior fibroids than for women with fibroids in other locations. 10 Various other studies have reported postoperative changes in LUTS, [11][12][13] and a potential relationship between leiomyoma/large uterine volumes and increased LUTS by using magnetic resonance imaging and ultrasonography.…”