To explore the diagnosis and treatment of interstitial bladder leiomyoma.

A retrospective analysis of 10 patients with interstitial bladder leiomyoma enucleation treated by the same group from January 2010 to January 2019 in Affiliated Hospital of Xuzhou Medical University was performed. The mean age was (44±6) years (range 33-51). Clinical manifestation included irritative bladder 5 cases, the symptoms of lower abdominal pain in 1 and absence of symptoms in 4. The mean course was 4.9 months (range 1 week-2 years). Color Doppler ultrasonography of the urinary system in 10 patients revealed a hypoechoic mass with a regular morphology on the bladder wall and a hyperechoic surface covering the mucosa. The CTU examination showed a homogenous solid mass in the bladder wall with a well-defined, smooth border and no erosive appearance, a naturally shaped bladder wall with a clear peri-mural fat space and a filling defect in the bladder. Cystoscopy showed that the surface mucosa of the tumor was often intact and continuous, showing a slight local bulge. According to the patient's tumor location and size, ten patients were treated with transurethral leiomyoma enucleation and laparoscopic leiomyoma enucleation, respectively. Intraoperative frozen section showed leiomyoma of the bladder in three patients.

Among the 10 patients who had clinical symptoms: 5 of them had bladder irritation as the main complaint. Postoperative symptoms were significantly relieved, and those with lower abdominal pain symptoms disappeared. None had complications. None had tumor recurrence or complained of urinary fistula or other common complications during postoperative follow-up of 4-24 months (16.43 months on average).

The combination of color Doppler ultrasonography, CTU and cystoscopy are the main method to diagnose intramural bladder leiomyoma. Transurethral leiomyoma enucleation and laparoscopic leiomyoma enucleation is a safe and effective surgical technique for treating subserosal bladder leiomyoma with excellent results.