Leiomyoma of the female urethra: urodynamic changes after surgical intervention

Leiomyoma of the urethra is a relatively rare condition often presenting as an anterior vaginal wall mass or a mass that protrudes from the urethral meatus. We report on the urodynamic changes after vaginal surgery to remove a suburethral leiomyoma, which protruded from the vaginal orifice resulting in dysuria and dyspareunia. Urodynamic studies before the operation revealed a high detrusor pressure, low maximum flow rate with an elevated post-void residual urine on voluntary voiding, and high resting urethral resistance. Removal of the mass with proper reconstruction of paraurethral support restored normal detrusor pressure, maximum flow rate, and post-void residual, resulting in amelioration of her voiding difficulty and dyspareunia. The operative procedure did not affect leak point pressure and she is free from stress urinary incontinence.