Outcomes of ureterolysis for primary retroperitoneal fibrosis: A single‐center experience. (21st January 2021)

• Record Type: Journal Article
• Authors: Bozaci, Ali Cansu; Altan, Mesut; Haberal, Hakan Bahadir; Söğütdelen, Emrullah; Aki, Fazil Tuncay; Erkan, İlhan
• Is Part Of: International journal of urology. Volume 28:Number 5(2021)
• Page Start: 520
• Page End: 525
• Publication Date: 2021-01-21
• Subjects: hydronephrosis -- outcome -- retroperitoneal fibrosis -- treatment -- ureterolysis; Urology -- Periodicals; Genitourinary organs -- Periodicals; Urologic Diseases -- Periodicals; 616.6005
• DOI: 10.1111/iju.14496
• Languages: English
• ISSNs: 0919-8172

Abstract

Abstract : Objective: To report our experience with ureterolysis for the management of retroperitoneal fibrosis. Methods: The data of 25 patients who underwent ureterolysis due to primary retroperitoneal fibrosis between 2002 and 2017 were reviewed retrospectively. Initial symptoms, laterality, renal function status (initial/final), operation complications and serum creatinine levels (diagnosis/preoperative/6 months, 12 months postoperatively) were recorded. After surgery, patients were followed up by ultrasonography and serum creatinine levels. Patients with impaired results underwent furosemide renogram and/or late phase of computed tomography. Factors affecting final serum creatinine levels were evaluated. The χ 2 ‐test was used for nominal data among groups. The level of statistical significance was set as P < 0.05. Results: A total of 19 patients (76%) were operated bilaterally. The mean follow‐up period was 46.2 ± 9.2 months. Among 44 operated renal units, non‐functioning kidney developed in seven (15.9%). A total of 34 renal units (77.3%) did not require any additional surgical intervention, and two underwent balloon dilatation (4.5%), one (2.25%) followed with double J stent changes. Two patients developed end‐stage renal disease secondary to bilateral unresolved obstruction. High final serum creatinine levels developed in eight (32%) patients without dialysis. Eight patients (32%) were treated with immunosuppressive therapy for systemic recurrence. There was a significant relationship between preoperative serum creatinine levels with final serum creatinine levels ( P = 0.005). There was no statistically significant relationship between diagnosis serum creatinine levels with final serum creatinine levels and postoperative dialysis requirement ( P = 0.79 and P = 0.817, respectively). Conclusions: Ureterolysis provides acceptable success with low complication rates in patients with retroperitoneal fibrosis. Preoperative high‐serum creatinine levels can be considered as a risk factor for long‐term renal impairment and these patients should be followed closely.