摘要
目的口服减肥药物治疗盆腔脂肪增多症3例,探讨该病的诊断、治疗和预后。方法3例男性患者,年龄38岁、52岁、58岁,行腹部平片、静脉肾盂造影(IVP)、CT,膀胱镜检查。均口服减肥药物治疗。治疗后1、3、6个月门诊复查。结果3例患者均有尿频、尿急、夜尿增多、大便困难等症状。其中1例患者伴有间断肉眼血尿,就诊时影像学诊断双肾积水。减肥药物治疗2周后3位患者的尿路刺激症状开始缓解,半年后体重明显减轻。肾积水患者半年后复查B超显示一侧肾积水消失,一侧肾积水减轻,血尿消失。结论盆腔脂肪增多症是一种少见的疾病,影像学检查可以确诊。减肥药物治疗可能是一种简单、有效、可靠的治疗方法。尽管盆腔脂肪增多症的病理学表现为良性病变,但由于会引起尿路梗阻而带来严重的病理生理后果,对盆腔脂肪增多症患者应以防止并发症的治疗为主,并密切随访。
Objective Pelvic lipomatosis is a rare disorder of benign mature adipose tissue proliferation around the bladder and rectum. Three cases of pelvic lipomatosis were reported, and the diagnostic, drug therapeutic and prognosis of pelvic lipomatosis were discussed. Methods Three males, aged 38, 52 and 58 respectively, presented irritative symptoms of lower urinary tract. One of them had discontinued gross hematuria and bilateral hydronephrosis when diagnosed. Intravenous pyelogram （IVP）, plain abdominal radiograph, computer tomography （CT） scan, and cystoscope were performed as diagnostic procedures. All were treated with orlistat. Results The pelvic lipomatosis was diagnosed just depending on imageology Intravenous urography classically showed a pear-shaped bladder. Pelvic CT revealed increased homogenous fat around a thickened bladder. The cystoscopy of one patient failed. The irritative symptoms of lower urinary tract of three patients were relieved after two weeks＇ treatment. The weight abated obviously after a half year. The patient with discontinued gross hematuria and bilateral hydronephrosis was checked by B ultrasonic （US） after a half year treatment, and the result showed that the hydronephrosis of one side disappeared~ the other hydronephrosis and hydroureter abated obviously; and the hematuria disappeared. Conclusion IVU and CT are valuable to confirm the diagnosis of pelvic lipomatosis, which can be treated with operation, antibiotic therapy, hormonal therapy, radiotherapy, chemotherapy, and dietary control etc. Drug therapy is simple and effective. Potential malignization of the bladder lesions in pelvic lipomatosis suggests aggressive treatment. Close follow-up of such patients is recommended.
出处
《现代泌尿外科杂志》
CAS
2007年第2期87-90,共4页
Journal of Modern Urology
