Pelvic lipomatosis: report of two cases

Pelvic lipomatosis （PL） is an overgrowth of pelvic adipose tissue, which surrounds and compresses the surrounding organs and changes its shape and position, resulting in obstruction of urinary system and lower digestive tract, thus a series of clinical symptoms. In this article, clinical data of 2 cases of PL was retrospectively analyzed. Two patients were admitted to our hospital due to the chief complaint of urine frequency and urgency, and diagnosed with PL by imaging examination. Case 1 was a young patient with severe clinical symptoms. Preliminary cystoscopy combined with pathological examination prompted the signs of glandular cystitis, and bladder perfusion treatment was delivered. In the late stage, relevant clinical symptoms of this patient were aggravated, and the patient underwent transurethral cystitis glandular resection + pelvic fat removal + bilateral ureterovesical replantation. Postoperative follow-up revealed that hydronephrosis was significantly relieved after surgery. The long-term results were satisfactory. Case 2 was an elderly patient presented with mild clinical symptoms and poor physical condition. Conservative treatment was given. The patient was followed up for 1 year, and the hydroureter of bilateral kidneys was not significantly alleviated, whereas relevant symptoms were slightly mitigated. These two cases prompted that PL is characterized with unique imaging features. Patients with slow progression and normal kidney function can be followed up on a regular basis. For elderly patients with poor physical conditions, urological modification surgery is recommended to improve relevant symptoms. For young patients with severe disease, it is of significance to relieve the obstruction symptoms, improve the quality of life, reduce the compression of pelvic fat on bladder, ureter and colorectal, and mitigate the symptoms of severe hydroureter and even renal failure or digestive tract symptoms caused by urinary tract obstruction.