Some clinical aspects of idiopathic retroperitoneal fibrosis

Abstract

A series of 40 patients with idiopathic retroperitoneal fibrosis is discussed with reference to some of the clinical observations. Among other conclusions it appears that corticosteroids should be used more in the treatment of this disease.

Retroperitoneal Fibrosis

“…Such therapy may exclude surgery provided biopsies are not needed or if the patient is in a high operative risk category [Ochsner et al, 1975;Mitchinson, 1972;Morandi and Grob, 1971;Wagenknecht and Hardy, 1981;Hollingworth et al, 1980], The value of corticosteroids in the postoperative period is still debated. Wagenknecht and Hardy [1981] state that without additional corticosteroid application, ureteral stenosis occurred 5 times more often than with steroids, whereas Kinder [1979] is of the opinion that recurrence after ureterolysis is the result of inadequate surgery and should not occur.…”

The pathology of idiopathic retroperitoneal fibrosis

“…Because descriptions of the morbid anatomy and histology are still incomplete a series of 40 patients was studied, with particular attention to the pathology (Mitchinson, 1969a). The clinical observations are summarized elsewhere (Mitchinson, 1970).…”

Steroid Therapy in Idiopathic Retroperitoneal Fibrosis: Report of Two Successful Cases

“…Response has been better in the early cellular phase of the disease than in the later fibrotic phase [6,8]. The major drawbacks in their use are the risks of dissemination of infec tion, due to its immunosuppressive side effects, and the possibility of its utilization in cases of misdiagnosed retroperitoneal malignancy [2,3]. Most authors, therefore, recommend its use only in patients without infection and who have biopsy-proved benign fibrosis…”

“…Their use is particularly recommended in patients with abnor malities that preclude surgery, and mainly in cases of ipsi-or contra lateral recurrences [2,3,8]. Response has been better in the early cellular phase of the disease than in the later fibrotic phase [6,8].…”

“…Since the first report on their use in association with ureterolysis, steroids have been used in idiopathic retroperitoneal fibrosis also as an alternative to surgery [2,[5][6][7][8].…”