Pelvic Lipomatosis With Ureteral Encasement and Recurrent Thrombophlebitis

Bechtold, Robert E.; Mi, Shaff

doi:10.1097/00007611-198308000-00023

Cited by 5 publications

(4 citation statements)

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“…Pain (flank or lower abdominal) is the most common symptom, and the wide range of other symptoms is secondary to the compression of pelvic structures—the genitourinary tract (lower urinary tract symptoms, hematuria, HUN, stones, and painful ejaculation), lower gastrointestinal tract (constipation, tenesmus, and rectal bleeding), and vascular system (edema of lower limbs and deep vein thrombosis) [4] , [15] , [16] . Complications include hypertension, renal failure, rarely bladder adenocarcinoma, pulmonary thromboembolism, portal vein thrombosis, and death [17] , [18] , [19] , [20] , [21] , [22] . All our patients presented with B/L flank pain (usually more on one side), and none had azotemia or hypertension.…”

Section: Discussionmentioning

confidence: 99%

Robotic Management of Pelvic Lipomatosis—Experience with Difficulties Encountered and the Techniques to Successful Outcomes

SanjayPrakash¹,

Thangarasu²,

Jain³

et al. 2020

European Urology Open Science

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Background Pelvic lipomatosis (PL) is a rare condition characterized by diffuse pelvic overgrowth of nonmalignant but infiltrative adipose tissue in perivesical and perirectal space. Objective To share our robotic experience and difficulties encountered and suggested techniques to overcome them successfully. It is the first series from India. Design, setting, and participants A prospective observational study was conducted. All consecutive patients diagnosed with PL between 2016 and 2019 underwent robotic-assisted wide bladder fat extirpation and bilateral ureteral reimplantation (extravesical refluxing type) with double J stenting and were evaluated prospectively. Outcome measurements and statistical analysis Demographics, serum creatinine level, radiographic features, postoperative complications, and patient-reported outcomes were evaluated. Continuous variables are presented as median and range, as the sample size is very small. Results and limitations We encountered a total of five patients with PL. The median console time was 126 (range 120–130) min, with a median estimated blood loss of 120 (range 100–150) ml. Postoperative complications were Clavien-Dindo grade I in three cases, and the median hospital stay was 2 d. Distal ureteric margins showed subepithelial edema with submucosal fibrosis, and bladder fat biopsies were reported as adipose tissue with hemorrhage. At initial 3-mo and annual follow-ups, all patients had normal serum creatinine and there was no evidence of disease recurrence. Limitations of our study are the very small sample size (a low incidence of PL) and short follow-up time period (the question of how long the surgical effect will be sustained due to abnormal proliferation of fat cells remains unanswered). Conclusions Robotic management of wide bladder fat extirpation and bilateral ureteral reimplantation with double J stenting has a good success rate and good outcome in PL. Patient summary Pelvic lipomatosis is a very rare condition. Robotic management in treating the condition has good outcome for the patient. Here, we have discussed the difficulties encountered in treating the condition and the techniques used to overcome them.

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Section: Discussionmentioning

confidence: 99%

Robotic Management of Pelvic Lipomatosis—Experience with Difficulties Encountered and the Techniques to Successful Outcomes

SanjayPrakash¹,

Thangarasu²,

Jain³

et al. 2020

European Urology Open Science

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“…The etiology of this disorder is unknown, but it is suggested that obesity plays a role, and it has been found in half of the patients afflicted with obesity [4,9]. This small incidence of renal failure is attributed to a gradual, progressive course of pelvic lipomatosis, and a high grade of obstruction [11]. Suprapubic pain or lumps, backache, flank pain, or perineal discomfort may be other clinical manifestations [10].…”

Section: Discussionmentioning

confidence: 99%

“…Approximately half of the patients present with lower urinary tract symptoms, and about a quarter present with bowel complaints. Venous stasis is due to the compression of iliac veins or vena cava [11][12][13]. Hypertension is common, occurring in 35 to 74% of patients [3].…”

Section: Discussionmentioning

confidence: 99%

Pelvic Lipomatosis: A Rare Case with a Good Surgical Outcome

Gupta¹,

Singh²,

Kumar³

et al. 2012

UIJ

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Pelvic lipomatosis is defined as a condition characterized by the diffuse proliferation of normal mature fatty tissue in the perirectal and perivesical region. We report a case of a 40-year-old, obese male who presented with marked lower urinary tract symptoms. Imaging studies and blood tests revealed bilateral hydroureteronephrosis and right non-excretory kidney with deranged renal function. Diagnosis of the pelvic lipomatosis was established on the basis of clinical and radiological findings. The patient was successfully managed by simple cystectomy and ileal conduit.After 6 years of follow-up, the patient is doing well with normal renal parameters.A 40-year-old, obese, normotensive, euglycemic patient presented in 2005 with increased frequency, urgency, urge incontinence, nocturnal enuresis, straining to void, and poor stream for 15 years. Symptoms had aggravated over the last year (2004). There was a history of low backache and erectile dysfunction for the last 6 months. His bowel function was normal and there was no edema of the lower limbs.

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“…The primary may be in stomach, pancreas, lung, breast, neuroendocrine tumour) But it is exceedingly uncommon to find ureteral obstruction due to metastases to the ureter from distant primary tumors. Until now, only about 400 cases confirmed by post-mortem have been reported [20,21].…”

Section: Neoplasmmentioning

confidence: 99%

Swathed Ureter, an Enigma in Diagnosis- A Pictorial Essay

Mohaideen¹

2021

JUNS

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This pictorial essay is an educational article aiming to provide both textual and visual portrayals consisting of a collection of images and texts on an important issue by reviewing and extrinsic encasing pathology of the ureter to provide a guide to those who are involved in diagnostic intervention. While considering diseases of the urinary system, physicians mainly focus on the kidneys and the bladder. Only scant attention is paid to the ureters. Most of the UTO due to calculi are readily identifiable whereas many cases of ureteric exterior encasement are frequently missed from early detection even by experienced clinicians and radiologists. Failure in recognition of the encasement of ureters and its causes may lead to mistaken diagnosis with resultant inappropriate management. However, problems with the ureters can adversely affect the functioning of the kidneys and could even be lethal. In this article we focus only 'encasement of ureters' with a few common examples and salient signs that help in the diagnosis.

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Pelvic Lipomatosis With Ureteral Encasement and Recurrent Thrombophlebitis

Cited by 5 publications

References 0 publications

Robotic Management of Pelvic Lipomatosis—Experience with Difficulties Encountered and the Techniques to Successful Outcomes

Robotic Management of Pelvic Lipomatosis—Experience with Difficulties Encountered and the Techniques to Successful Outcomes

Pelvic Lipomatosis: A Rare Case with a Good Surgical Outcome

Swathed Ureter, an Enigma in Diagnosis- A Pictorial Essay

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