Vaginal fibromyomata: two cases with preoperative assessment, resection, and reconstruction

Vaginal fibromyomata are rare benign neoplasms; approximately 300 have been reported in the world literature. The clinical presentation is variable and the consistency of the mass on pelvic examination may be misleading. A mass may occur anywhere along the vaginal tube and is usually localized, mobile, nontender, and circumscribed. Its consistency, however, may range from solid to cystic. These lesions may be asymptomatic or may cause pain or urinary tract symptoms. Transabdominal and intravaginal sonography along with needle biopsy are valuable in making the preoperative diagnosis of a benign smooth-muscle tumor. Vaginal enucleation is the treatment of choice. Operative management should include evaluation of urethrovesical support and possible reconstruction, eg, pubourethral ligament plication.