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Outcomes of ureterolysis for primary retroperitoneal fibrosis: A single‐center experience
Author(s) -
Bozaci Ali Cansu,
Altan Mesut,
Haberal Hakan Bahadir,
Söğütdelen Emrullah,
Aki Fazil Tuncay,
Erkan İlhan
Publication year - 2021
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.14496
Subject(s) - medicine , ureterolysis , creatinine , renal function , urology , retroperitoneal fibrosis , nephrology , surgery , dialysis , fibrosis
Objective To report our experience with ureterolysis for the management of retroperitoneal fibrosis. Methods The data of 25 patients who underwent ureterolysis due to primary retroperitoneal fibrosis between 2002 and 2017 were reviewed retrospectively. Initial symptoms, laterality, renal function status (initial/final), operation complications and serum creatinine levels (diagnosis/preoperative/6 months, 12 months postoperatively) were recorded. After surgery, patients were followed up by ultrasonography and serum creatinine levels. Patients with impaired results underwent furosemide renogram and/or late phase of computed tomography. Factors affecting final serum creatinine levels were evaluated. The χ 2 ‐test was used for nominal data among groups. The level of statistical significance was set as P < 0.05. Results A total of 19 patients (76%) were operated bilaterally. The mean follow‐up period was 46.2 ± 9.2 months. Among 44 operated renal units, non‐functioning kidney developed in seven (15.9%). A total of 34 renal units (77.3%) did not require any additional surgical intervention, and two underwent balloon dilatation (4.5%), one (2.25%) followed with double J stent changes. Two patients developed end‐stage renal disease secondary to bilateral unresolved obstruction. High final serum creatinine levels developed in eight (32%) patients without dialysis. Eight patients (32%) were treated with immunosuppressive therapy for systemic recurrence. There was a significant relationship between preoperative serum creatinine levels with final serum creatinine levels ( P = 0.005). There was no statistically significant relationship between diagnosis serum creatinine levels with final serum creatinine levels and postoperative dialysis requirement ( P = 0.79 and P = 0.817, respectively). Conclusions Ureterolysis provides acceptable success with low complication rates in patients with retroperitoneal fibrosis. Preoperative high‐serum creatinine levels can be considered as a risk factor for long‐term renal impairment and these patients should be followed closely.