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.