Drug treatment of pelvic lipomatosis (report of 3 cases)

    He Dalin, Zhao Jun, Liu Runming, He Hui, Wang Mingzhu, Nan Xunyi

    (Department of Urology, The First Affiliated Hospital, Medical School of Xi¬ðan Jiaotong University, Xi¬ðan 710061, China)

    ABSTRACT: Objective Pelvic lipomatosis is a rare disorder of benign mature adipose tissue proliferation around the bladder and rectum. Three cases of pelvic lipomatosis were reported, and the diagnostic, drug therapeutic and prognosis of pelvic lipomatosis were discussed. Methods Three males, aged 38, 52 and 58 respectively, presented irritative symptoms of lower urinary tract. One of them had discontinued gross hematuria and bilateral hydronephrosis when diagnosed. Intravenous pyelogram (IVP), plain abdominal radiograph, computer tomography (CT) scan, and cystoscope were performed as diagnostic procedures. All were treated with orlistat. Results The pelvic lipomatosis was diagnosed just depending on imageology. Intravenous urography classically showed a pearª²shaped bladder. Pelvic CT revealed increased homogenous fat around a thickened bladder. The cystoscopy of one patient failed. The irritative symptoms of lower urinary tract of three patients were relieved after two weeks¬ð treatment. The weight abated obviously after a half year. The patient with discontinued gross hematuria and bilateral hydronephrosis was checked by B ultrasonic (US) after a half year treatment, and the result showed that the hydronephrosis of one side disappeared; the other hydronephrosis and hydroureter abated obviously; and the hematuria disappeared. Conclusion IVU and CT are valuable to confirm the diagnosis of pelvic lipomatosis, which can be treated with operation, antibiotic therapy, hormonal therapy, radiotherapy, chemotherapy, and dietary control etc. Drug therapy is simple and effective. Potential malignization of the bladder lesions in pelvic lipomatosis suggests aggressive treatment. Close followª²up of such patients is recommended. ......