Bladder Leiomyoma

　　1. Etiology

　　The etiology of bladder smooth muscle tumors is not yet clear. Some authors believe it is related to inflammatory stimulation or embryonic factors. Bladder smooth muscle tumors are more common in women, and the age of onset is similar to that of uterine fibroids, and the incidence of bladder smooth muscle tumors complicated with uterine fibroids reaches 10%, indicating that the occurrence of bladder smooth muscle tumors may be related to endocrine factors.

　　2. Pathogenesis

　　According to the relationship between the tumor site and the bladder wall, it is divided into three types: submucosal, interstitial, and subserosal bladder. Among them, the submucosal type is the most common, accounting for about 63%, followed by the subserosal type, accounting for about 30%, and the interstitial type accounting for 7%. The tumor grows in an expansive manner, and the submucosal smooth muscle tumor can sometimes form a pedunculated bladder tumor. The tumor is often located on the posterior wall of the bladder, with a complete capsule. The size of the tumor ranges from a few millimeters to several centimeters, with an average diameter of about 6 cm; most are solitary, and there are also reports of multiple occurrences in China and abroad. Histological observation shows that the tumor is composed of well-differentiated smooth muscle cells, the tumor cells are fusiform, the cytoplasm is abundant, the boundary is clear, there are longitudinal myofibrils, and the staining is deep pink. The nuclei are rod-shaped, blunt at both ends, without atypia and without nuclear division. The tumor cells aggregate into bundles, forming a woven or whorled arrangement, and there is sometimes an unequal amount of fibrous tissue between the smooth muscle fibers.

　　When the cancer involves the ureteral orifice, it can cause obstruction of the ureteral orifice, leading to hydronephrosis of the pelvis at the obstruction site. In severe cases, due to significant increase in intracystic pressure, it can cause a decrease in glomerular filtration rate, impeding the excretion of creatinine and urea nitrogen, and even lead to renal insufficiency. If complications of infection occur, hematuria can worsen, and symptoms such as frequent urination, urgency, and fever may appear. Patients with persistent hematuria may also develop anemia due to hemorrhage.

　　The clinical manifestations of bladder smooth muscle tumors are related to the type and location of the tumor. Submucosal tumors are mainly manifested by hematuria. When the tumor is large or located near the urethral orifice, it can manifest as frequent urination, difficulty in urination, and even acute urinary retention due to tumor obstruction of the urethra or extrusion from the urethra. Interstitial tumors have no symptoms in the early stage, and when the tumor is large, it can also cause hematuria, frequent urination, or difficulty in urination. Subserosal tumors are mainly manifested as pelvic masses.

　　Since the etiology of bladder smooth muscle tumors is not yet fully clear, the methods of prevention are nothing more than:

　　1. Minimize infection and avoid contact with radiation and other harmful substances, especially drugs that suppress the immune function;

　　2. Appropriate exercise, enhance physical fitness, and improve one's ability to resist diseases.

　　It is mainly to prevent various factors that may lead to bladder smooth muscle tumor. It is currently believed that the loss of normal immune surveillance function, the tumor-promoting effect of immunosuppressants, the activation of potential viruses, and the long-term application of certain physical (such as radiation) and chemical (such as antiepileptic drugs, adrenal cortical hormones) substances may all lead to the proliferation of lymphoreticular tissue, and eventually result in bladder smooth muscle tumor. Therefore, attention should be paid to personal and environmental hygiene, avoid drug abuse, and pay attention to personal protection when working in harmful environments.

　　1. Urinalysis: Red blood cells may be present when hematuria is present.

　　2. Ultrasound examination can determine the size, location, and extent of the tumor, which is the most economical and practical examination method for diagnosing bladder smooth muscle tumor, and can be performed through the abdomen or rectum. It usually appears as a hypoechoic mass, the bladder mucosa surface of the tumor is hyperechoic, CT shows a solid tumor of the bladder wall, with a CT value of about 30Hu. When the tumor is large, there may be a necrotic area in the center of the tumor. MRI can determine the size, location, and extent of the tumor through coronal, sagittal, and transverse scanning, and can also understand the condition of adjacent organs. Bladder wall masses covered with normal bladder mucosa should be considered as bladder smooth muscle tumors, but when the mucosa surface of the tumor forms ulcers or erosions, it is easy to be misdiagnosed as malignant tumors.

　　What kind of food is good for bladder smooth muscle tumor patients to eat:

　　Diet should be normal, eat more lean meat, chicken, eggs, crucian carp, turtle, cabbage, asparagus, celery, spinach, cucumber, winter melon, mushrooms, tofu, kelp, seaweed, fruits, etc.

　　1. Treatment

　　Bladder smooth muscle tumor is a benign tumor, and the treatment should be based on the principle of preserving the bladder. Small tumors may not require treatment, small tumors can be removed through the urethra, and tumors larger than a certain size or interstitial or subserosal type can be removed by tumor resection or partial bladder resection.

　　2. Prognosis

　　This disease belongs to a benign disease, there is a possibility of recurrence after surgery, but the prognosis of bladder smooth muscle tumor is good.