Diagnosis and treatment of hydronephrosis induced by retroperitoneal fibrosis(a report of 52 cases)

Objective To explore the diagnosis and treatment of hydronephrosis caused by retroperitoneal fibrosis(RPF),and to improve the rate of early diagnosis.Methods The clinical data of 52 cases of hydronephrosis caused by RPF treated in our hospital during the past 10 years were retrospectively analyzed.Results Double-J-catheter were placed in 7 cases under cystoscope or ureteroscope and these patients took glucocorticoid and tamoxifen at the same time.Ureterolysis and double-J-catheter were performed in 45 cases,11 of which had double-J-catheter placed at the first stage and underwent ureterolysis after renal function was improved.Of the 45 patients who received ureterolysis,35 had ureter moved to abdominal cavity,and 10 had the ureter enveloped with a piece of pediculated omentum.Pathological examination after surgery revealed fibrofatty tissue with inflammatory cell infiltration.During the follow-up of 1 month to 10 years,all 52 cases had clinical symptoms relieved renal function improved.Conclusions For patients with hydronephrosis identified by B ultrasound,calculus,neoplasm,ureteropelvic junction obstruction,retroperitoneal fibrosis and other diseases should be taken into consideration.Further examinations,such as IVU,CT and ureteroscopy are necessary to confirm the diagnosis before operation.The treatment for retroperitoneal fibrosis is mainly to relieve ureter obstruction,protect renal function and reduce recurrence.