目的    提高盆腔脂肪增多症的诊断及治疗水平。 方法    苏州大学附属第一医院泌尿外科2009年2月至2012年3月共收治5例盆腔脂肪增多症病人，对其临床表现、影像学资料及诊疗过程进行分析，结合相关文献讨论盆腔脂肪增多症诊治要点及预后情况。 结果    B超检查均表现为膀胱位置及形态改变、膀胱颈周围均匀强回声、双侧肾盂输尿管不同程度扩张积水；静脉尿路造影（IVU）检查显示后尿道延长，膀胱抬高，呈“竖直灯泡”形。CT检查见盆腔内均匀低密度脂肪影，膀胱有不同程度受压、变形、移位及上抬。3例行手术治疗，术中见盆腔膀胱输尿管周围大量增多脂肪，行脂肪清除术+双侧输尿管膀胱再植术。1例行经尿道腺性膀胱炎电切+双侧内支架管置入，另1例定期随访。术后随访肾盂输尿管积水较术前减轻。 结论    盆腔脂肪增多症临床表现不典型，B超、IVU及CT检查可作为该病确诊依据，对于病情重、年龄轻的病人可考虑手术治疗，效果满意。而肾功能良好的病人可定期随访。

Diagnosis and treatment of pelvic lipomatosis：A report of 5 patients        ZHOU Jia-he, PU Jin-xian, PING Ji-gen. Department of Urology, the First Affiliated Hospital of Soochow University, Suzhou 215000,China
Corresponding author ：PU Jin-xian，E-mail：pjx62@sina.com
Abstract    Objective    To improve diagnosis and treatment of pelvic lipomatosis in clinical practice. Methods    There were 5 male patients with pelvic lipomatosis admitted between February 2009 and March 2012 in the First Affiliated Hospital of Soochow University. They were analyzed in the study with combination of the clinical characteristic, imaging studies, diagnosis and treatment. The clinical characteristics of pelvic lipomatosis were reviewed by combination with the literature.  Results    Ultrasonography showed bladder deformity and bladder position change, around the neck of bladder had a uniform strong echo and extension of ureters, and also hydronephrosis both side; A typical "vertical buld" shape of bladder, elevated  bladder and extended posterior were seen on IVU. CT scan showed there were even distribution of low-density adipose tissues in pelvic cavity and varying degree of compression, deformation, displacement and elevation of bladder, part of the vertex of urinary bladder over the sacrum. Three patients underwent pelvic adipose dissection and uretero-grafting surgery, apparently increased lipid tissue was found in the pelvic cavity and there was large amount of lipid tissue around the bladder and ureters during the surgery. One patient underwent transurethral resection of glandular cystitis and double J ureteral catheter placement on ureteroscopy. One patient was followed up regularly. Postoperative hydronephrosis was relieved gradually. Conclusion    B ultrasonography, IVU and CT scan are the most valuable examinations in diagnosis of pelvic lipomatons. Open operation and double J ureteral catheter placement are effective treatments of pelvic lipomatosis. The patient with good kidney function can be performed regular follow-up.