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Organo Oficial de la Sociedad Mexicana de Urología

2009, Number 4

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Rev Mex Urol 2009; 69 (4)

Conservative treatment in retroperitoneal fibrosis

Martínez-Arroyo C, García-Villa PC, Salgueiro-Ergueta R, Paredes-Mendoza J, Zarate-Osorno A, Marina-González JM

Language: Spanish
References: 16
Page: 170-173
PDF size: 130.49 Kb.


ABSTRACT

Background: Retroperitoneal fibrosis is classified as idiopathic or secondary. It was discovered by Albarran (1905) and described by Ormond (1948) as a fibrotic process tending to affect the ureter.
Objective: To present a case of idiopathic retroperitoneal fibrosis and its conservative management.
Materials and Methods: The case of a patient with idiopathic retroperitoneal fibrosis with bilateral ureteropyelohydronephrosis and acute renal insufficiency is presented.
Results: After exploratory laparoscopy, and supported by immunohistochemistry, definitive diagnosis was idiopathic retroperitoneal fibrosis. Treatment was initiated with 20 mg daily of prednisone that was gradually reduced to 5 mg daily, serum creatinine and urea were improved and there was no retroperitoneal fibrosis reactivation at 3-year follow-up.
Discussion: Retroperitoneal fibrosis can be managed with medical treatment based on steroids and immunosuppressors or surgery.
Conclusions: A steroid regimen may be used as first line treatment for the majority of patients with a minimum of complications, along with periodic evaluation for the remainder of their lives.


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