ESR1 and urethra leiomyoma: Some studies propose a correlation between the development of urethral leiomyoma and estrogen levels in the body, same to uterine leiomyoma.[7,8] Previous research has confirmed that a significant proportion of urethral leiomyoma samples express estrogen receptors (ER), indicating a potential role of the ER signaling pathway in leiomyoma progression.