Leiomyoma of the female urethral meatus presenting as a periurethral mass: a case report

Urethral leiomyomas are rare benign tumours. Fewer than a hundred cases have been reported. We report a case of a distal urethral leiomyoma presenting as a painless vaginal mass without urinary symptoms. A 26-year-old nulliparous woman noticed a gradually enlarging vaginal mass following a prolonged cough. She denied any urinary symptoms. Examination revealed a 5 × 5 cm smooth mass at the urethral meatus. MRI showed a solid, vascularised periurethral tumour. Cystourethroscopy confirmed a normal urethral lumen and bladder. Complete excision was performed. Histopathology was consistent with leiomyoma. Postoperative recovery was uneventful, and she remained recurrence-free and asymptomatic 6 months after surgery. Distal urethral leiomyomas, although rare, should be considered in the differential diagnosis of vaginal masses. In this case, complete excision was associated with symptom resolution and no recurrence at 6 months, although longer follow-up is required to confirm durable absence of recurrence.