We describe a rare case of circumferential urethral leiomyoma causing chronic urinary retention.

The mass was stable for years but contributed to long-term catheterization difficulty.

Transvaginal partial excision improved symptoms while minimizing surgical morbidity.

First report describing vaginal excision of a circumferential urethral leiomyoma.

MRI and biopsy were key in diagnosis, guiding a targeted surgical approach.

We present a rare case of a 68-year-old female with urinary retention and a peri-urethral mass. The patient, with a history of thoracic aortic aneurysm, was referred to urology after a urethral mass was incidentally detected on CT imaging during aneurysm surveillance. Pelvic MRI identified a 4.8 cm circumferential, enhancing mass along the proximal urethra. A transvaginal ultrasound-guided biopsy confirmed a low-grade smooth muscle neoplasm, consistent with leiomyoma. The mass was successfully excised via a transvaginal approach. This case highlights the importance of a broad differential in female urinary retention and demonstrates the feasibility of vaginal excision for peri-urethral masses.

Voiding dysfunction

Urinary retention

Urethral mass

© 2025 The Authors. Published by Elsevier Inc.