Pear-Shaped Bladder

Abstract

History A 40-year-old man had a history of backache and recurrent urinary infection. A year previous to this he had been treated for ureteric obstruction. On rectal examination the prostate was not enlarged, but a soft mass was palpable in the pelvis. Figure 1 is a section of the scout film, and Fig 2 is the bladder area of the 20-minute film of an excretory urogram. Diagnosis Pelvic lipomatosis. Comment In Fig 1 there is increased radiolucency in the pelvis with good visualization of muscle planes and bony detail, consistent with excessive fatty tissue. Figure 2 shows bilateral and symmetrical compression of the bladder, which is pear-shaped and extends from the pelvis. Deviation and compression of the ureters with partial obstruction is present. The upper tracts were normal. The differential diagnosis of the pear-shaped bladder includes pelvic hematoma, pelvic edema and collaterals from venous obstruction, enlarged glands secondary to lymphoma