Difficult cystoscopy due to "Elongated" urethra- think of pelvic lipomatosis

Pelvic lipomatosis is a rare, proliferative disease with unknown etiology involving an overgrowth of normal fat in the pelvic retroperitoneal space. ^1-5 Cystitis glandularis or cystitis cystica can be observed in 75% of patients with pelvic lipomatosis. ⁵ We describe a 44-yr-old chronic smoker with suspicion of bladder mass who was referred to us following an inconclusive cystoscopy due to an "elongated" urethra and was later diagnosed to be a case of pelvic lipomatosis with cystitis cystica. Because the association of this condition with bladder adenocarcinoma and the possibility of obstructive uropathy later, we have kept the patient on close follow-up.