Surgical treatment of retroperitoneal fibrosis

Objective To evaluate the effect of surgical treatment on patients with retroperitoneal fibrosis. Methods The medical records of 24 retroperitoneal fibrosis patients (19 men and 5 women;mean age,52 years) who had been surgically treated from January 1985 to December 2003 were retrospectively analyzed.The initial clinical presentations included low back and abdominal pain in 11 cases,acute anuresis in 5 and incidental bilateral hydronephrosis in 8.Double-J inter-ureter drainage was performed in 11 cases, among whom the procedure failed in 4 cases, and then they underwent pricking pyelostomy.After their general condition improved,ureterocutaneostomy and ureterolysis were performed in 2 cases and 1 case, respectively.Of them 1 case died of acute myocardial infarction 3 months later.Thirteen cases who had good general condition at diagnosis underwent ureterolysis. Results One patient developed renal function failure due to repeated urinary infection 3 years after operation.One died of acute myocardial infarction 3 months after operation.The other 22 patients recovered well,and their mean creatinine level decreased from 450.9μmol/L before operation to 318.2 μmol/L (1 month) and 265.2 μmol/L (3 months),respectively,after operation. Conclusions Prompt and appropriate relief of urinary obstruction with surgical treatment can effectively protect the renal function in patients with retroperitoneal fibrosis.