Difficult cystoscopy due to “Elongated” urethra- think of pelvic lipomatosis

Shekar, P. Ashwin; Reddy, Dinesh

doi:10.1016/j.eucr.2020.101492

Cited by 4 publications

(3 citation statements)

References 5 publications

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“…Modified Ileal Conduit for Pelvic Lipomatosis therapeutic strategies of PL include conservative treatment and surgical treatment [4,[17][18][19]. Urinary diversion is recommended when PL patient experiences persistent hydronephrosis after ureteral stent placement, significant changes in bladder morphology, severe damage to the lower urinary tract function, or unsuccessful ureteral stent placement.…”

Section: Perioperative and Follow-up Resultsmentioning

confidence: 99%

Modified Ileal Conduit for Pelvic Lipomatosis: Technique Description and Outcome

Xia,

Meng,

Zhang

et al. 2024

Urol Int

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Introduction: The aim of this study was to present the surgical technique and clinical outcomes of modified ileal conduit for pelvic lipomatosis (PL). Methods: From 2020 to 2022, we prospectively enrolled 9 patients with PL undergoing modified ileal conduit. The patient characteristics, perioperative variables, and follow-up outcomes as well as the description of surgical technique were reported. Results: All 9 patients successfully completed the operation. Two patients had perioperative complications of Clavien-Dindo grade I. The mean operation time and bleeding volumes were 253 ± 51.4 min and 238.9 ± 196.9 mL, with a mean postoperative follow-up time of 13.0 ± 5.6 months. The postoperative 3-month and 1-year creatinine values were significantly decreased versus the preoperative (p = 0.006 and p = 0.024). The postoperative 3-month and 1-year estimated glomerular filtration rate values were significantly increased compared with those before operation (p = 0.0002 and p = 0.018). The separation value of left renal pelvis collection system after operation was significantly reduced compared with preoperative evaluation (p = 0.023 at 3 months and p = 0.042 at 1 year) and so was the right side (p = 0.019 and p = 0.023). Conclusion: Modified ileal conduit is safe and feasible for PL. A large sample cohort with long-term follow-up is needed to evaluate the clinical outcomes of PL.

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Section: Perioperative and Follow-up Resultsmentioning

confidence: 99%

Modified Ileal Conduit for Pelvic Lipomatosis: Technique Description and Outcome

Xia,

Meng,

Zhang

et al. 2024

Urol Int

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“…A total of 42 studies, 1 – 3 , 7 – 45 including 231 patients with PL were finally included in this systemic review. The detailed literature search process is illustrated in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Conservative treatment mainly includes hormones, antibiotics, weight loss, and diet management, 2 but its efficacy is limited. 3 – 5 Surgical treatments for PL include transurethral resection (TUR), ureteral stent placement, urinary diversion, and allograft kidney transplantation. To our knowledge, studies have yet to systematically review surgical treatments for PL.…”

Section: Introductionmentioning

confidence: 99%

Surgical treatment of pelvic lipomatosis: a systematic review of 231 cases

Xia,

Xiong,

et al. 2023

Therapeutic Advances in Urology

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Background: Pelvic lipomatosis (PL) is a rare condition that is characterized by excessive growth of fat in the pelvic cavity. Studies have yet to systematically review surgical treatments for PL. Objectives: To provide a reference for selecting reasonable surgical treatments for PL patients according to previous literature on the surgical treatment of PL. Design and methods: We conducted this systematic review in accordance with the Preferred Reporting Items for a Systematic Review and Meta-Analysis (PRISMA) of Individual Participant Data guidelines. Literature on PL published from 1968 to 2022 was retrieved from the PubMed and EMBASE databases. Data were collected and analyzed independently by two independent investigators. Results: A total of 42 studies, involving 231 patients with PL, were included in the analysis. The surgical treatments included transurethral resection (TUR) (48.5%), ureteral stent placement (11.7%), percutaneous nephrostomy (1.3%), ureterocutaneostomy (1.3%), ureteral reimplantation (10.4%), ileal conduit (13%), and allograft kidney transplantation (0.4%). After excluding patients with unclear prognoses, 42.9% of patients showed improvement in lower urinary tract symptoms (LUTS) after TUR. Ureteral stent placement provided relief of hydronephrosis in 62.5% of PL patients. Percutaneous nephrostomy resulted in stable renal function in 33.3% of PL patients, while ureterocutaneostomy led to remission of postoperative hydronephrosis in 33.3% of PL patients. After ureteral reimplantation, 70.8% of patients experienced relief of hydronephrosis or had stable renal function. Ileal conduit led to remission of hydronephrosis, alleviation of symptoms, or maintenance of stable renal function in 83.3% of PL patients. One patient with PL had stable renal function after allograft renal transplantation. Conclusion: The surgical treatments for PL include TUR, ureteral stent placement, urinary diversion, and allograft renal transplantation. However, the choice of surgical method should be determined after comprehensive consideration of the patient’s condition.

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Pelvic lipomatosis associated with bilateral obstructive uropathy and proliferative cystitis

2021

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Pelvic lipomatosis is a rare benign entity characterised by excessive deposition of adipose tissue in the perirectal and perivesical spaces. We describe a 43-year-old man with bilateral distal ureteral obstruction secondary to pelvic lipomatosis with concomitant proliferative cystitis resulting in severe hydronephrosis. We performed urinary diversion with percutaneous nephrostomy tube insertion to prevent further renal impairment. The patient was advised close follow-up to monitor the increased risk of bladder adenocarcinoma transformation observed in patients with cystitis glandularis. This report, compliant with the CARE (CAse REport) guidelines for clinical case reporting, presents another case of pelvic lipomatosis associated with acute kidney failure, bilateral hydronephrosis and proliferative cystitis without urodynamic evidence of bladder outlet obstruction that may serve to guide urologists in managing patients with a similar profile.

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Difficult cystoscopy due to “Elongated” urethra- think of pelvic lipomatosis

Cited by 4 publications

References 5 publications

Modified Ileal Conduit for Pelvic Lipomatosis: Technique Description and Outcome

Modified Ileal Conduit for Pelvic Lipomatosis: Technique Description and Outcome

Surgical treatment of pelvic lipomatosis: a systematic review of 231 cases

Pelvic lipomatosis associated with bilateral obstructive uropathy and proliferative cystitis

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