女性尿道平滑肌瘤的诊断和治疗

Diagnosis and therapy of female urethra leiomyoma

目的分析女性尿道平滑肌瘤的临床特征,探讨该疾病的诊断、治疗及预后。方法结合该院2016年收治的1例女性尿道平滑肌瘤病例资料,复习国内共36篇文献71例患者的病例资料,总结所有患者的临床表现、治疗方法及预后。结果我国女性尿道平滑肌瘤临床表现为尿道口肿块[81.7%(58/71)],性生活不适[4.2%(3/71)],排尿时会阴部撕裂样疼痛[2.8%(2/71)],阴道前壁肿块[2.8%(2/71)],无症状体征[4.2%(3/71)]。肿块多位于尿道外口[91.5%(65/71)],其次为尿道内口[7.0%(5/71)],尿道中段[2.8%(2/71)]。所有患者术后罕见复发。该院收治的1例女性尿道平滑肌瘤临床表现为阴道前壁肿块。结论女性尿道平滑肌瘤为罕见的尿道良性肿瘤,B超可以初步鉴别肿块的囊实性,磁共振成像可以判断肿块的位置及周围组织的解剖关系。沿肿瘤包膜外游离完整剥除肿瘤,可以减少术后复发率,该病确诊尚需依赖术后病理明确。

Objective The clinical characteristics female urethral leiomyoma were analyzed,and the diagnosis,treatment and prognosis of the disease were discussed. Methods Combined with 1 case of female urethral leiomyoma in the hospital in2016,the clinical data of 71 cases were reviewed the domestic 36 literatures to summarize clinical manifestations,treatment,and prognosis. Results The main clinical manifestation of female urethral leiomyoma in our country was the mass of urethral orifice[81.7%（58/71）],sexual discomfort[4.2%（3/71）],perineal tearing pain when urinating [2.8%（2/71）],vaginal anterior wall mass[2.8%（2/71）],asymptomatic physical examination found[4.2%（3/71）]. Tumors were usually located in the urethral orifice[91.5%（65/71）],followed by urethral mouth[7.0%（5/71）],middle urethra[2.8%（2/71）]. All patients had a rare recurrence after surgery.The clinical manifestation of 1 case of female urethral leiomyoma in the hospital was the anterior wall mass of the vagina. Conclusion Female urethral leiomyoma is a rare urethral benign tumor. B-ultrasound can be a preliminary identification of cystic-solid lesions of the tumor. Magnetic resonance imaging can judge the location of the tumor and the anatomical relationship with the sur-rounding tissue. Surgical removal of tumors along the tumor capsule can reduce the chance of recurrence after surgery. Making a definite diagnosis depends on the postoperative pathology.