Associated Findings and Complications of Retroperitoneal Fibrosis in 204 Patients: Results of a Urological Registry
2010; Lippincott Williams & Wilkins; Volume: 185; Issue: 2 Linguagem: Inglês
10.1016/j.juro.2010.09.105
ISSN1527-3792
AutoresAlexander Sascha Brandt, Lars Kamper, S. Kukuk, Patrick Haage, Stephan Roth,
Tópico(s)Abdominal Trauma and Injuries
ResumoNo AccessJournal of UrologyAdult Urology1 Feb 2011Associated Findings and Complications of Retroperitoneal Fibrosis in 204 Patients: Results of a Urological Registry A.S. Brandt, L. Kamper, S. Kukuk, P. Haage, and S. Roth A.S. BrandtA.S. Brandt Department of Urology, Helios Klinikum Wuppertal, University of Witten/Herdecke, Wuppertal, Germany , L. KamperL. Kamper Department of Diagnostic and Interventional Radiology, Helios Klinikum Wuppertal, University of Witten/Herdecke, Wuppertal, Germany , S. KukukS. Kukuk Department of Urology, Helios Klinikum Wuppertal, University of Witten/Herdecke, Wuppertal, Germany , P. HaageP. Haage Department of Diagnostic and Interventional Radiology, Helios Klinikum Wuppertal, University of Witten/Herdecke, Wuppertal, Germany , and S. RothS. Roth Department of Urology, Helios Klinikum Wuppertal, University of Witten/Herdecke, Wuppertal, Germany View All Author Informationhttps://doi.org/10.1016/j.juro.2010.09.105AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We studied the frequency of associated findings and complications of retroperitoneal fibrosis in a large clinical collective of urological patients. Materials and Methods: All urology departments in Germany were invited to participate in a registry of patients with retroperitoneal fibrosis, for which a data sheet with more than 200 questions was developed. Results: As of March 2010 a total of 204 patients were registered. The male-to-female ratio was 2.1:1 and the average age at onset was 55.6 years. In 123 cases (60.3%) the diagnosis was confirmed by histopathology. Coexisting autoimmune diseases were found in 9.8% of patients, consisting mainly of thyroid disorders. Coexisting fibrosis was detected in 3.4% of the patients and 73.9% of those queried were active smokers. Of 176 patients for whom data on therapy were available 123 received monotherapy and 41 received combination therapy for a mean of 12.1 months (12 received none), while 87 underwent a total of 103 operative procedures. Hydronephrosis was the most frequent complication in 95.6% of patients. Atrophic kidney from undetected hydronephrosis appeared in 46 patients (22.5%) and in 4 bilateral damage necessitated dialysis. Complications from vascular obstruction were observed in 27.5% of patients. Large bowel obstruction requiring colostomy occurred in 4 patients (2.0%). Conclusions: Patients with retroperitoneal fibrosis often first present to urology departments upon referral for hydronephrosis. In this series at least 1 kidney appeared to be irreversibly damaged in more than 20% of patients. Urologists should be mindful of the role of smoking role as a risk factor, complications arising from vascular and large bowel obstructions, and the possible association of retroperitoneal fibrosis with autoimmune disease. References 1 : Retroperitoneal fibrosis. Lancet2006; 367: 241. Google Scholar 2 : Reténtion rénale par péri-urétérite: Libération externe de l'utétère . Assoc Fr Urol1905; 9: 511. Google Scholar 3 : Bilateral ureteral obstruction due to envelopment and compression by an inflammatory retroperitoneal process. J Urol1948; 59: 1072. Link, Google Scholar 4 : Idiopathic retroperitoneal fibrosis: a review of the pathogenesis and approaches to treatment. Am J Kidney Dis2009; 54: 546. Google Scholar 5 : Idiopathic retroperitoneal fibrosis: A retrospective analysis of 60 cases . Br J Urol1987; 60: 497. Google Scholar 6 : Symptoms and diagnosis of retroperitoneal fibrosis: Analysis of 31 cases . Urol Int1971; 26: 185. Google Scholar 7 : ["Retroperitoneal Fibrosis" (RPF) Urologic Cooperation and Research Project]. Urologe A2007; 46: 1302. Google Scholar 8 : Idiopathic retroperitoneal fibrosis: a discussion of the etiology. J Urol1965; 94: 385. Link, Google Scholar 9 : A review of retroperitoneal fibrosis. J Urol1964; 92: 323. Link, Google Scholar 10 : Surgical treatment of retroperitoneal fibrosis. Ann Surg1969; 169: 610. Google Scholar 11 : [Treatment outcomes in primary and secondary retroperitoneal fibrosis]. Urologe A2000; 39: 141. Google Scholar 12 : The clinical significance of retroperitoneal fibrosis. Surgery1977; 81: 250. Google Scholar 13 : Retroperitoneal fibrosis. Neth J Med2002; 60: 231. Google Scholar 14 : Retroperitoneal fibrosis. AJR Am J Roentgenol1991; 157: 321. Google Scholar 15 : [Retroperitoneal fibrosis]. Aktuelle Urol2007; 38: 221. Google Scholar 16 : Retroperitoneal fibrosis and ankylosing spondylitis: which links?. Semin Arthritis Rheum2005; 35: 43. Google Scholar 17 : Autoimmune aspects of chronic periaortitis. Autoimmun Rev2006; 5: 458. Google Scholar 18 : Retroperitoneal fibrosis and p-ANCA-associated polyarteritis nodosa: coincidental or common etiology?. Eur J Intern Med2002; 13: 392. Google Scholar 19 : Surgery for idiopathic retroperitoneal fibrosis by ureterolysis and ureteric protection with a posterior pre-peritoneal fat flap. BJU Int2002; 89: 783. Google Scholar 20 : Evidence of autoimmunity in chronic periaortitis: a prospective study. Am J Med2003; 114: 454. Google Scholar 21 : Asbestos exposure as a risk factor for retroperitoneal fibrosis. Lancet2004; 363: 1422. Google Scholar 22 : Chronic periaortitis: a spectrum of diseases. Curr Opin Rheumatol2005; 17: 34. Google Scholar 23 : Immunosuppressive therapy for idiopathic retroperitoneal fibrosis: a retrospective analysis of 26 cases. Am J Med2004; 116: 194. Google Scholar 24 : Brief communication: tamoxifen therapy for nonmalignant retroperitoneal fibrosis. Ann Intern Med2006; 144: 101. Google Scholar 25 : The association of retroperitoneal fibrosis with systemic vasculitis and HLA-B27: a case report and review of the literature. J Rheumatol1981; 8: 665. Google Scholar 26 : Retroperitoneal fibrosis: A radiological and follow-up study of fourteen cases . Q J Med1969; 38: 159. Google Scholar 27 : Retroperitoneal fibrosis and large bowel obstruction: case report and review of the literature. Ann Surg1972; 176: 199. Google Scholar 28 : A rare case of idiopathic retroperitoneal fibrosis involving obstruction of the mesenteric arteries, duodenum, common bile duct, and inferior vena cava. Intern Med2003; 42: 812. Google Scholar 29 : Idiopathic retroperitoneal fibrosis with duodenal obstruction successfully treated with corticosteroids. Intern Med1998; 37: 592. Google Scholar 30 : [Problem of intestinal compression due to retroperitoneal fibrosis]. Chirurg1975; 46: 473. Google Scholar © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byMishra K, Zargar H, Tarplin S, Ramanathan R and Stein R (2018) Idiopathic Retroperitoneal FibrosisJournal of Urology, VOL. 193, NO. 5, (1657-1658), Online publication date: 1-May-2015. Volume 185Issue 2February 2011Page: 526-531 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Keywordsregistriescomplicationsretroperitoneal fibrosisMetricsAuthor Information A.S. Brandt Department of Urology, Helios Klinikum Wuppertal, University of Witten/Herdecke, Wuppertal, Germany More articles by this author L. Kamper Department of Diagnostic and Interventional Radiology, Helios Klinikum Wuppertal, University of Witten/Herdecke, Wuppertal, Germany More articles by this author S. Kukuk Department of Urology, Helios Klinikum Wuppertal, University of Witten/Herdecke, Wuppertal, Germany More articles by this author P. Haage Department of Diagnostic and Interventional Radiology, Helios Klinikum Wuppertal, University of Witten/Herdecke, Wuppertal, Germany More articles by this author S. Roth Department of Urology, Helios Klinikum Wuppertal, University of Witten/Herdecke, Wuppertal, Germany More articles by this author Expand All Advertisement PDF downloadLoading ...
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