Long-Term Outcome of Ureterolysis and Omental Wrapping for Idiopathic Retroperitoneal Fibrosis - European Medical Journal

Long-Term Outcome of Ureterolysis and Omental Wrapping for Idiopathic Retroperitoneal Fibrosis

1 Mins
*Mohamed H. Zahran, Yasser Osman
EMJ Urol. ;5[1]:41-42. Abstract Review No. AR4.
Retroperitoneal fibrosis (RPF), ureteral obstruction, ureterolysis, omental wrapping, renal function

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Retroperitoneal fibrosis (RPF) is a rare fibroblastic inflammatory process that involves the retroperitoneum over the lower four lumbar vertebrae and entraps one or both ureters.1 One hundred years after the first description by Albarran, the treatment of choice for RPF-induced ureteral obstruction is still a matter of debate. This may be explained by the rarity of the disease and the different pathological subtypes.1 The aim of the treatment is to preserve renal function and to keep patients free of stents.2 We evaluated the long term functional outcome of ureterolysis and omental wrapping (UOR) for idiopathic RPF. Twenty-one patients (17 males and 4 females) were treated by UOR. After a median of 25 (interquartile range: 12–125) months, there were statistically insignificant changes in serum creatinine and estimated glomerular filtration rate (p=0.5 and 0.9, respectively). Renal function remained stable or improved in 12 (57%) of cases. Nine (21.4%) renal units still harboured double J stents. Preoperative hydronephrosis improved or stabilised in 90% of renal units. Intraoperative complications had been inflected in 5 (23.8%) patients and included ureteral injury, inferior vena cava injury, and duodenal serosal injury in 3 patients, 1 patient, and 1 patient, respectively. All were managed intraoperatively with no postoperative sequelae. In conclusion, UOR has a good long-term renal function outcome as it avoids internal ureteral stent fixation in 78.6% of renal units.

Vaglio A, Maritati F. Idiopathic Retroperitoneal Fibrosis. J Am Soc Nephrol. 2016;27(7):1880-9. Fernando A et al. A lot of questions (and a few answers…) in retroperitoneal fibrosis. BJU Int. 2016;117(1):16-9.

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