Minimally Invasive Transvaginal Resection of a Rectovaginal Septal Leiomyoma

A 28-year-old patient was admitted to our hospital with a rectovaginal septum mass that was an incidental finding by physical examination. The patient was asymptomatic. Magnetic resonance imaging (MRI) was performed to assess the relationship between the tumor and the surrounding tissues. MRI revealed a solid mass with distinct borders in the rectovaginal septum measuring 4.4 cm × 3.8 cm × 4.9 cm (Fig. 1). Tumor markers were negative. On physical examination, the mass had well-defined edges and was not tender on palpation. Transvaginal surgery was performed with the patient positioned in the lithotomy position under general anesthesia. An incision was made into the vaginal mucosa at the surface of the tumor, and the open space surrounding the tumor was exposed (Fig. 2). The tumor was removed intact with no injury to the rectal muscles (Fig. 3). The vaginal mucosa was sutured using 2-0 absorbable suture material. Pathology results showed the mass was a leiomyoma. The patient reported no discomfort postoperatively. At their 1-month follow-up appointment, the vaginal wound was observed to have healed. Fig. 2A mass like a myoma was taken out of the rectovaginal septum. View Large Image Figure Viewer Download Hi-res image Fig. 3The mass was solid and its diameter was approximately 5 cm. View Large Image Figure Viewer Download Hi-res image