Extrauterine leiomyoma is a very rare clinical condition; we report a case of leiomyoma of the Retzius space in a 49-year-old women who suffered for two years from bladder voiding symptoms characterized by dysuria, feeling of incomplete emptying, and pelvic pain. Clinical evaluation and abdominal and transvaginal ultrasound suggested the presence of a voluminous (about 10 cm in diameter) fibromyoma of the anterior uterus surface. The urodynamic evaluation demonstrated the presence of bladder outlet obstruction (voiding pressure greater than 20 cm H2O and maximum flow rate less than 12 mL/s) with a postvoiding urine residual equal to 80 mL; moreover, the presence of cystocele and urethral stricture was ruled out performing clinical evaluation, cystography, and cystourethroscopy. The patient underwent laparotomy to remove the uterine fibromyoma. Intraoperatively, a voluminous soft mass arising from the Retzius space was found; it was firmly adhered to the uterus with obliteration of vesicouterine pouch owing to severe adhesion to the anterior surface of uterus. The tumour was isolated, enucleated from the prevesical space, and removed; moreover, the patient became asymptomatic after surgery. In conclusion, leiomyoma of the Retzius space is a very rare benign tumour that should be considered in the presence of severe bladder voiding symptoms.
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机译：子宫外平滑肌瘤是一种非常罕见的临床疾病。我们报告了一名49岁女性Retzius空间平滑肌瘤的案例，该女性患有以排尿困难，排尿不完全和骨盆疼痛为特征的膀胱排空症状，为期两年。临床评估以及腹部和经阴道超声检查提示子宫前表面存在大量（直径约10？cm）纤维肌瘤。尿流动力学评估表明存在膀胱出口梗阻（无效压力大于20 cm H2O，最大流速小于12 mL / s），尿后残余尿量等于80 mL。此外，排除了进行临床评估，膀胱造影和膀胱尿道镜检查时是否存在膀胱膨出和尿道狭窄。该患者接受了剖腹手术以切除子宫纤维肌瘤。术中发现了由Retzius空间引起的大量软肿块。由于严重粘附在子宫的前表面，它被牢固地粘附在子宫上，并闭塞了膀胱子宫袋。分离肿瘤，将其从膀胱前间隙摘除，然后切除。此外，患者在手术后无症状。总之，Retzius空间平滑肌瘤是一种非常罕见的良性肿瘤，应在出现严重的膀胱排尿症状时予以考虑。
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