Management of Idiopathic Retroperitoneal Fibrosis, a Retrospective Study at Prince Hussein Urology and Organ transplantation center (PHUO), Jordan

Abstract

Introduction: to study the presentation, clinical course, laboratoryresults, imaging findings, medical and urological treatments ofidiopathic retroperitoneal fibrosis at our institution.

Methods: Between January 2006 and December 2017, medical recordsand operatives' notes of 116 patients with idiopathic retroperitonealfibrosis (IPRF) were reviewed retrospectively. Diagnosis was doneby clinical and radiological imaging that fulfilled a strict criterion.All patients were initiated on Prednisolone 60 mg for two months,and reduced until reaching 10 mg daily, with a total duration of24 months in the responding patients. Renal drainage was done incases of obstructed kidneys. To assess response, both laboratoryresults and imaging studies at initiation and after 4 months werereviewed and compared.

Results: Of 116 patients diagnosed with IRPF, eighty five (73.3%)were male and thirty one (26.7%) female, with mean ± SD age atpresentation was (50.5 ± 10.6) years. 79% of the patients complaintof abdominal and low back pain, 27% uremic symptoms, 10.3% hada new onset of hypertension, 3.4% presented with anejaculation,and 13.8% were totally asymptomatic. Uretric obstruction hadbeen resolved in 132 ureters after a mean of 152 days of treatment.Almost 30 % reduction in the fibrotic mass size was achieved in82 % of patients.

Conclusion: Glucocorticoids is the the mainstay of treatment. Therenal function tests, of the vast majority of patients, normalizedwith treatment. Relapse may occur, so a follow-up over a longperiod of time is required. A high index of suspicion is neededfor diagnosis in asymptomatic patients.