Safety analysis of ureterolysis for ureteric obstruction secondary to retroperitoneal fibrosis
- PMID: 40140108
- DOI: 10.1007/s00345-025-05576-7
Safety analysis of ureterolysis for ureteric obstruction secondary to retroperitoneal fibrosis
Abstract
Purpose: Ureterolysis is an uncommonly performed surgery for management of retroperitoneal fibrosis. This study sought to utilize a large, multi-centered database to assess the short-term post-operative outcomes of patients undergoing ureterolysis surgery for retroperitoneal fibrosis.
Methods: Using the American College of Surgeons National Quality Improvement Program database, a retrospective review was conducted on patients who underwent ureterolysis for retroperitoneal fibrosis between January 1st, 2006, and December 31st, 2016. Patients who underwent ureterolysis for retroperitoneal fibrosis as a principle operative procedure by a urologist were included. Complications within 30 days of surgery were captured and organized based on the Clavien-Dindo classification system. The prevalence of secondary reconstructive urologic procedures performed at the time of ureterolysis (ureteroureterostomy, ureteroneocystostomy, and ureteroneocystostomy with psoas hitch/bladder flap) was determined.
Results: One hundred patients (51 male, 49 female) were included in the cohort, with a mean age of 57 (IQR 43 and 66, respectively). Of these, six underwent a secondary urological procedure at the time of ureterolysis (1 ureteroureterostomy, 2 ureteoneocystostomy, and 3 ureteroneocystostomy with psoas hitch/bladder flap). The overall complication rate was 12%. Of the patients affected, 92% experienced only Clavien grade I or II complications (wound or urinary infection). Only one patient required return to the operating room (Clavien III) and there were no high-grade complications (Grade IV or V).
Conclusion: Ureterolysis for retroperitoneal fibrosis is an uncommonly performed surgery with generally low incidence of post-operative complications. Ureterolysis may represent a safe treatment option for ureteric obstruction secondary to retroperitoneal fibrosis.
Keywords: Post-operative complications; Retroperitoneal fibrosis; Ureterolysis; Urology.
© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Conflict of interest statement
Declarations. Competing interests: The authors declare no competing interests.
Similar articles
-
Contemporary role of ureterolysis in retroperitoneal fibrosis: treatment of last resort or first intent? An analysis of 50 cases.BJU Int. 2017 Oct;120(4):556-561. doi: 10.1111/bju.13915. Epub 2017 Jun 18. BJU Int. 2017. PMID: 28502080
-
Comparison of laparoscopic with open approach for ureterolysis in patients with retroperitoneal fibrosis.J Urol. 2008 May;179(5):1875-8. doi: 10.1016/j.juro.2008.01.030. Epub 2008 Mar 18. J Urol. 2008. PMID: 18353394
-
Robot-assisted reconstructive surgery of the distal ureter: single institution experience in 16 patients.BJU Int. 2013 May;111(5):773-83. doi: 10.1111/j.1464-410X.2012.11673.x. Epub 2013 Jan 10. BJU Int. 2013. PMID: 23305121
-
[Ureterolysis: technique, indications].Ann Urol (Paris). 2005 Feb;39(1):1-9. doi: 10.1016/j.anuro.2004.12.001. Ann Urol (Paris). 2005. PMID: 15830549 Review. French.
-
3D Laparoscopic Ureterolysis for Retroperitoneal Fibrosis Secondary to Radical Hysterectomy and Radiation Treatment for Cervical Cancer: Results from the Oncological Institute, Cluj Napoca.Arch Esp Urol. 2023 Sep;76(7):519-524. doi: 10.56434/j.arch.esp.urol.20237607.64. Arch Esp Urol. 2023. PMID: 37867337 Review.
References
-
- Ormond JK (1948) Bilateral ureteral obstruction due to envelopment and compression by an inflammatory retroperitoneal process. J Urol 59:1072–1079. https://doi.org/10.1016/S0022-5347(17)69482-5 - DOI - PubMed
-
- Scheel PJ, Feeley N (2013) Retroperitoneal fibrosis. Rheum Dis Clin North Am 39:365–381. https://doi.org/10.1016/j.rdc.2013.02.004 - DOI - PubMed
-
- Tzou M, Gazeley DJ, Mason PJ (2014) Retroperitoneal fibrosis. Vasc Med Lond Engl 19:407–414. https://doi.org/10.1177/1358863X14546160 - DOI
-
- Zahran MH, Osman Y, Soltan MA et al (2017) Idiopathic retroperitoneal fibrosis: clinical features and long-term renal function outcome. Int Urol Nephrol 49:1327–1334. https://doi.org/10.1007/s11255-017-1608-9 - DOI - PubMed
-
- Fernando A, Pattison J, Horsfield C et al (2016) A lot of questions (and a few answers… in retroperitoneal fibrosis. BJU Int 117:16–19. https://doi.org/10.1111/bju.13061 - DOI - PubMed
MeSH terms
LinkOut - more resources
Full Text Sources
Medical