Transvesical laparoscopy for bladder leiomyoma excision: a novel surgical technique

Introduction and hypothesis Leiomyomas of the urinary bladder are rare tumors. Submucosal leiomyomas, when small and easily accessible, can be treated with transurethral resection, while unfavorably positioned or larger leiomyomas may be treated through an abdominal approach. In these cases, a laparoscopic approach for intravesical surgery is an alternative that may be considered. We aim to demonstrate a novel transvesical laparoscopic approach to bladder leiomyoma excision with a video. Methods A 45-year-old woman with urinary symptoms and a 40-mm submucosal bladder leiomyoma located at the interureteric ridge was referred to our hospital (tertiary referral hospital). Due to the location and size of the leiomyoma, and to increase the probability of complete resection, a transvesical laparoscopic approach was decided. A step-by-step video is presented to describe the surgical technique. Results There were no intra- or postoperative complications. The patient was discharged 48 h after the surgery. At 60 months’ follow-up, the patient remains asymptomatic. Conclusions Transvesical laparoscopy may be considered for excision of bladder leiomyomas. This approach is feasible for trained surgeons as it requires a small working space.