Pelvic Lipomatosis: Bladder Sparing Extirpation of Pelvic Mass with Ureteral Reimplantation

Abstract

Background Pelvic lipomatosis is a proliferative disease characterised by excessive fat growth in retroperitoneal space leading to inadequate bladder drainage and ureteral compression. Cystitis glandularis, cystitis cystica, or cystitis follicularis can be found in majority of patients with the disease.Case Presentation We report a case of a 63-year-old man diagnosed outside our hospital with pelvic lipomatosis after finding of pelvic mass behind the bladder causing severe bilateral hydronephrosis. A bladder–sparing excision of the pelvic lipomatosis mass with bilateral ureteric reimplantation was performed, thereby avoiding the need for urinary diversion.Conclusion For patients suffering from pelvic lipomatosis and bilateral hydronephrosis, relief of obstructions to the urinary tract should be prioritized. This can be achieved through traditional surgery such as a ureteral stent insertion, or more radical surgical options such as a total cystectomy and urinary diversion. There have been recent reports of success found in bladder-sparing techniques using mass extirpation and ureteral reimplantation.