Pelvic lipomatosis: urodynamic characters and clinical significance / 中华泌尿外科杂志

Objective To study the urodynamic characters of pelvic lipomatosis(PL) and its clinic significance.Methods From Sep.2013 to Feb.2016,7 patients,including 6 males and one female,were diagnosed as PL by image examinations and related lower urinary tract syndrome.Their mean age was 46 years,ranged from 30 to 52 years.All the patients(study group) have normal renal function.However,4 patients were noticed bilateral hydronephrosis.Other patients with similar LUTS but were confirmed as normal by image and urodynamic examinations were concluded in control group,which was paired designed to match the study group in visiting time,gender,age,and number of patients.The uroflowmetry and pressure/flow cystometry were performed in all patients.The urodynamic data of two groups including maximum flow rate (Qmax),time to maximum flow,post-voiding residual (PVR),first sensation capacity,first desire to void capacity,cystometric capacity,intravesical pressure at terminal of filling phase,compliance,detrusor pressure at maximum flow,detrusor opening pressure,bladder outlet obstruction index (BOOI) and bladder contractility index (BCI),were retrospectively analyized.Results There were no significant different between study aud control groups respect to Qmax [(18.71 ± 10.31) ml/min vs.(13.29 ± 6.55) ml/min],time to maximum flow [(6.71 ±2.50)s vs.(7.43±2.76)s],PVR [(28.14±27.81)ml vs.(3.14± 3.48) ml],first sensation capacity[(138.86 ± 77.01) ml vs.(142.29 ± 89.84) ml],first desire to void capacity [(203.71 ± 131.09) ml vs.(216.57 ± 72.20) ml],cystometric capacity [(271.0 ± 151.95) ml vs.(323.29± 92.87)ml],i ntravesical pressure at terminal of filling phase [(30.29 ± 16.45)cmH2O vs.(18.71 ± 9.57) cmH2 O],and compliance [(90.53 ± 126.46) cmH2O/ml vs.(129.57 ± 136.25) cmH2O/ml].The study group was significant higher than control group in terms of pressure at maximum flow [(69.57 ±25.06) cmH2O vs.(33.14 ± 11.63) cmH2O,P =0.004],opening pressure [(42.57 ± 22.16)cmH2O vs.(18.00±13.18) cmH2O,P=0.027],BOOI [(34.00±15.92)vs.(16.50±5.96),P=0.030] and BCI [(133.17 ± 27.37) vs.(87.67 ± 20.16),P =0.008],respectively.Moreover,the BCI of PL patients with hydronephrosis were significant higher compare with PL patients without hydronephrosis [(155.67 ±14.98) vs.(110.67 ± 1 1.37),P =0.014].Conclusions The urodynamic characters of PL were increased pressure at maximum flow and opening pressure,which implied obstruction.

Imaging findings and clinical manifestations of pelvic lipomatosis:a report of 3 cases / 中华全科医师杂志

The imaging findings of pelvic lipomatosis as confirmed by operation and pathology were examined in 1 case and two follow-up asymptomatic cases retrospectively analyzed.The imaging findings included a compressed and deformed bladder with a superior displacement.Its shape was like an inverted tear and pear in coronal view and a banana in sagittal view.Bilateral ureters were both compressed with a medial deviation.And bilateral ureters were dilated with hydronephrosis in 1 case.Rectum and sigmoid were both compressed and became narrowed.The clinical manifestations included frequent urination , urgent urination , urination pain, dysuria, constipation, nausea, vomit and fever in 1 case while another 2 cases stayed asymptomatic.

Lipomatose pélvica: relato de caso e revisão da literatura / Pelvic lipomatosis: a case report and literature review

A lipomatose pélvica é uma doença rara, na qual se observa acúmulo de tecido adiposo na pelve causando compressão extrínseca da bexiga, reto e vasos sanguíneos. Neste estudo relatamos o caso de um paciente do sexo masculino, 48 anos de idade, que apresentou dores lombares e síndrome disúria-polaciúria. São descritos os achados na urografia excretora, tomografia computadorizada e ressonância magnética.

Pelvic lipomatosis is a rare disorder where fat tissue deposition is observed in spaces of the pelvic area, causing extrinsic compression of the bladder, rectum and blood vessels. In the present report, the authors describe the case of a 48-year-old male patient presenting low back pain, dysuria and pollakiuria. Findings at excretory urography, computed tomography and magnetic resonance imaging are described.

Pelvic lipomatosis in an asymptomatic Asian man: a case report

Pelvic lipomatosis is a rare disease of unknown cause, characterised by overgrowth of benign mature fat cells commonly located in the perivesical and perirectal spaces. The disease is rare amongst Asian population and has a wide range of presenting symptoms varying from lower urinary tract symptoms to bowel symptoms. However, this disease can be easily diagnosed based on certain characteristic radiological imaging techniques. We report a case of pelvic lipomatosis in an asymptomatic Chinese gentleman, who presented with classical radiological features of pelvic lipomatosis but provided us with challenging therapeutic scenario. (JUMMEC 2010; 13(2): 111-114)

Clinical analysis of eight cases of pelvic lipomatosis / 基础医学与临床

Objective To improve the understanding of pelvic lipomatosis.Methods The clinical features of eight patients(males,aged 26-64years) with pelvic lipomatosis who were admitted to Peking Union Medical College Hospital from 1983 to November 2006 were reviewed.The clinical and pathologic features,treatment and prognosis were analyzed.The course of disease before admission was(95?82)months,The period of follow-up was(15?32)months,five cases under went upper tract urinary diversion,one case had urinary tract diversion and received steroids,one case received steroids treatment only.Results Four cases had cystitis glandularis,frequency and urgency of micturition were observed in three cases.Dysuria in three cases,hematuria in three cases,and hypertension in five cases were recorded during the course of disease.Renal insufficiency was observed in all of eight cases(Mean Ccr was 76?18mL/min).All cases had abnormal features in their image investigation,which indicated excessive pelvic fat directly or indirectly.Six cases had upper tract distention.Four cases underwent pelvic tissue biopsy.The result of biopsy was fat-vessel tissue.Their symptoms,not renal function,were relieved after treatment.Conclusion The symptoms of pelvic lipomatosis are atypical,they had renal insufficiency,and their diagnosis mainly depends on image investigation and pathologic examination.

A Case of Pelvic Lipomatosis Associated with Cystitis Glandularis / 대한비뇨기과학회지

Pelvic lipomatosis is a rare disease of unknown etiology characterized by overgrowth of mature, nonmalignant fat cells in the pelvis, especially in the perivesical and perirenal space. An overgrowth of fat surrounding the bladder and rectosigmoid colon produces a radiologic picture characterized by 1) radiolucent pelvic densities, 2) elevation and vertical elongation of the bladder, 3) straightening and elevation of the rectosigmoid colon and 4) absence of malignant vessels on pelvic angiography. Cystoscopy has shown a high incidence of cystitic changes: chronic inflammation, cystitis glandularis and cystitis cystica. We report a case of pelvic lipomatosis associated with cystitis glandularis.

Diagnosis and treatment of pelvic lipomatosis / 中华泌尿外科杂志

Objective To improve the awareness of pel vi c lipomatosis in clinical practice. Methods A 51-year- old male patient with pelvic lipomatosis was admitted. Imaging studies showed th at there was mild degree of hydronephrosis on his both sides on IVU and a typica l inverted-pear shape of bladder and extended posterior urethra were also seen on IVU.CT scan showed that low density lipid piled in the pelvic cavity.MRI show ed obvious thickened soft tissue lesion around the bladder,rectum and in the pel vic cavity. The lesions in the pelvic cavity and around the ureters were removed and the lower segments of the ureters were loosened by laparoscopic surgery. Th e clinical characteristics of lipomatosis were reviewed by combination with the literature. Results Intraoperatively,apparently increase d lipid tissue was found in the pelvic cavity and there was large amount of lipi d tissue filling the space around bladder,rectum and sigmoid colon.This finding was consistent with the imaging study findings.About 500g lipid tissue was remov ed in the laparoscopic procedure.Pathologic study showed it was mature lipid tis sue.The patient was discharged 1 week after surgery.Two weeks after surgery,B-u ltrasound showed that there was improvement of hydronephrosis on both sides.The maximum width of right renal fluid sonolucent area decreased from 2.9 cm to 2.0 cm;the width of right upper ureter decreased from 1.2 cm to 1.0 cm;the maximum w idth of left renal pelvis decreased from 1.8 cm to 1.3 cm;and the width of left upper ureter decreased from 0.8 cm to 0.5 cm. Conclusions X-ray,CT scan and MRI are the most valuable examinations in the diagnosis of lipomatosis.Removing the lipid in the pelvis and around the bladder and loosenin g the ureters by laparoscopic surgery are minimally invasive,safe and effective in the treatment of pelvic lipomatosis.

A case of pelvic lipomatosis / 대한비뇨기과학회지

Pelvic lipomatosis is a condition characterized by a nonmalignant overgrowth of normal fat in the perirectal and perivesical spaces in the pelvis which may be to occur obstructive uropathy. On cystography the full bladder has an abnormal shape as a gourd, banana, pear or inverted tear-drop. Compulerized tomography shows the bladder and rectosigmoid surrounded and displaced by homogeneous tissue with a low attenuation coefficient and the CT features provide diagnostic proof or pelvic lipomatosis. We present a case of pelvic Lipomatosis.

A Case of Pelvic Lipomatosis / 대한비뇨기과학회지

Pelvic lipomatosis is a self-limiting disease of unknown etiology. It has been defined as a nonmalignant overgrowth of normal fatty tissue limited. Primarily to the perivesical and perirectal space in the pelvis which may be to go obstructive uropathy. Typically, urinary tract roentgenographys show a high, gourd-shaped bladder. Computed tomography provided definitive proof that pelvic organ displacement was due to excessive fat. We present a case of this pelvic lipomatosis.

A Case of Pelvic Lipomatosis / 대한비뇨기과학회지

Pelvic lipomatosis is a rare condition characteristized by the deposition of an excessive amount of benign adipose tissue in the bony pelvis. Tile proliferating adipose tissue may compress the pelvic viscera in varying degrees, including the pelvic portion of the ureters. Occasionally, marked bilateral ureteral obstruction may lead to the development of uremia. Computed tomography is emerging as useful diagnostic adjuvants in the confirmation of pelvic lipomatosis. A case of pelvic lipomatosis studied by CT and conventional radiography is presented.

A Case of Pelvic Lipomatosis / 대한비뇨기과학회지

Pelvic lipomatosis is a very rare condition in which a proliferative process involving the mature fat of the pelvic retroperitoneal space. An X-ray in such cases is characteristic and shows radiolucency of the soft pelvic tissue and bladder is displaced upward and has a gourd-like or inverted tear-drop appearance. In Korea, there is no previous report. Herein we report a case of pelvic lipomatosis and the literatures are reviewed.