• Saida Abrar and Raheela Mohsin.
• Department of Obstetrics and Gynaecology, The Aga Khan University Hospital, Karachi, Pakistan.
• J Coll Physicians Surg Pak. 2022 Dec 1; 32 (12): SS143SS145SS143-SS145.

AbstractVaginal leiomyomas are extremely rare in pregnancy. These can present in a variety of ways. They can cause mechanical obstruction leading to maternal and perinatal morbidity. Herein, we describe a patient with a vaginal leiomyoma misdiagnosed and operated as pelvic organ prolapse during the second trimester of pregnancy. She presented with a huge vaginal mass, foul-smelling vaginal discharge, difficulty in urination and defecation and septicemia. On examination, she had a large foul-smelling and necrotic mass protruding from the vagina with urethra lying outside the vagina, and sutures visible just above the mass on the anterior vaginal wall. She was admitted and a  lower segment caesarian section was done followed by transvaginal resection of the mass, and cystoscopy was done. Vaginal leiomyomas require surgical removal and it is usually curative and recommended as the initial treatment of choice, especially when the tumour is large enough to cause a potential obstacle to normal labour. Key Words: Vaginal leiomyoma, Pelvic organ prolapse, Pregnancy.

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