A case of leiomyoma of the urinary bladder, a rare benign tumor, in a 56-year-old female first seen with bilateral flank pain radiating to both groins, is reported. Examination showed a well developed female with obesity (260 pounds) and elevated blood pressure (132/90 mmHg). Evaluation with ultrasound, cystoscopy, urodynamics, and cytology contributed to the diagnosis of urinary bladder leiomyoma. Ultrasound detected a mass in the urinary bladder, and it was confirmed by cystoscopy to be a 5 cm to 6 cm bladder mass on the anterior bladder wall. The mass was prolapsing as a ball valve into the urethra at the level of the bladder neck. Frozen section of the mass showed it to be leiomyoma.
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