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Acute urinary retention caused by a uterine leiomyoma: a case report
Joseph M Novi1, Alka Shaunik, Beth H K Mulvihill
1Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia 19104, USA. jnovi@obgyn.upenn.edu
Background:
Large uterine leiomyomas may cause acute urinary retention from bladder outlet obstruction.
Case:
A 46-year-old, premenopausal, multiparous woman presented to a large, urban, university emergency department, where a diagnosis of acute urinary retention from uterine prolapse was made. An indwelling Foley catheter was placed. A week later the patient presented to an urogynecologist's office for evaluation of the prolapse and urinary retention. Physical examination showed an 18-20-week-sized uterus with a posterior lower uterine segment leiomyoma displacing the cervix anteriorly, causing bladder outlet obstruction, and no evidence of pelvic organ prolapse. The obstruction was relieved by total abdominal hysterectomy with bilateral salpingo-oophorectomy.
Conclusion:
A large uterine leiomyoma obstructed the bladder neck and presented as urinary retention.
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