Pelvic lipomatosis with ureteral calculi managed by flexible ureteroscopy A case report

Rationale: Pelvic lipomatosis (PL) is a benign disease characterized by overgrowth of adipose tissue in pelvic space. Hydronephrosis and ureterectasis are common complications caused by PL in urinary system. But PL accompanied with upper urinary tract calculi is rare. Also there has been no report of PL with ureteral calculi managed by flexible ureteroscopy (fURS). Patient concerns: A 62-year-old man who has been diagnosed of PL was found to have a right-side ureteral calculi by ultrasound in the routine health examination. In addition, the patient has a history of open surgery of uretero-vesical reimplantation in the left side 13 years ago because of heavy hydronephrosis in the left side. Diagnoses: The diagnosis was PL with ureteral calculi in the right side and heavy hydronephrosis in the left side. Interventions: FURS was performed to remove the right ureteral calculi. Outcomes: A follow-up of 1 year showed that there was no progression of the hydronephrosis in right side and serum creatinine was stable. Lessons: FURS is a suitable option for the upper urinary tract calculi accompanied with anatomical abnormality such as horseshoe kidney, pelvic ectopic kidney and so on. For patient of PL accompanied with upper urinary tract calculi, fURS is suitable and indicated.