Diagnosis and treatment of Idiopathic retroperitoneal fibrosis associated with hydronephrosis

Objective:To investigate the diagnosis and treatment for idiopathic retroperitoneal fibrosis ( IRF) associated with hydronephrosis.Methods:The clinical data of 12 IRF cases were analyzed retrospectively. The initial clinical manifestations of IRF includ lower backache,abdominal pain. CT scan was more sensitive than B-ultrasonography in detecting the masses in retroperitoneal space. Preoperative diagnosis was established in 83.3% of cases. Ureterolysis and wrapping up with the omentum or intraperitonialisation were performed on 12 cases with ureteral obstruction. Double-J inter-ureter drainage was performed on 2 cases, 1 case failed and underwent percutaneous nephrostomy.Results:At the last follow up, 10 of these patients has no recurrence. One patient is treated again for homolateral hydronephrosis recurrence. Another patient repeatedly undergoes surgical procedure because contralateral hydronephrosis .Conclusions:The patient with abdominal pain, lower backache should be alert of IRF. Combined CT scan and B ultrasonography help diagnose IRF before operation.The Ureterolysis and wrapping up with the omentum or intraperitonialisation are the treatment of choice.