Contemporary role of ureterolysis in retroperitoneal fibrosis: treatment of last resort or first intent? An analysis of 50 cases

BJU International
Tim O'Brien, Archie Fernando

Abstract

To determine the outcomes of open ureterolysis in a contemporary cohort of patients presenting with ureteric obstruction secondary to retroperitoneal fibrosis (RPF). We conducted a prospective analysis of 50 patients undergoing open ureterolysis and omental wrap between January 2012 and January 2016 in a single centre, managed by a multi-disciplinary RPF team. Patients had a minimum follow-up of 1 year. Indications were: nephrostomy-dependent drainage (n = 5); stent failure as evidenced by persistent hydronephrosis (n = 20); severe stent symptoms (n = 22); and patient choice/pre-emptive (n = 3). Outcome measures were stent-free rate; change in renal function post-ureterolysis; operating variables (operating time, blood loss, complications, length of hospital stay); and need for further intervention. Of the 50 patients, 48 (96%) were stent-free at 3 months and 47/50 (94%) were stent-free at 12 months. The median (interquartile range [IQR]) changes in glomerular filtration rate, according to these indication groups, at 1 year were: overall +6 (-4 to +22)% (P < 0.05); stent failure +25 (+5 to +27)% (P < 0.001); stent symptoms +0 (-17 to +6)% (P = 0.834); nephrostomy-dependent drainage -10 (-19 to -2)% (P = 0.731); and pre-emptive ...Continue Reading

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Citations

Mar 14, 2020·International Journal of Urology : Official Journal of the Japanese Urological Association·Toshiaki Tanaka, Naoya Masumori

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