Treatment of idiopathic retroperitoneal fibrosis

Speaking of "idiopathic retroperitoneal fibrosis", I believe everyone is relatively unfamiliar with it. Even clinically confirmed cases are rare. It should be said that retroperitoneal fibrosis is a very typical symptom of idiopathic peritonitis. It is also called in many ways, including sclerosing retroperitoneal granuloma, fibrous retroperitoneitis, etc. Today we mainly provide information about treatment for popularization.

There are two common treatment methods:

1. Glucocorticoids

Early use of glucocorticoids can be effective within a few weeks and can even significantly reduce or eliminate the tumor. For patients with mild to moderate urinary tract lesions, the elderly and frail, or those with systemic diseases, prednisone-type drugs are more appropriate.

It is sometimes used as preoperative preparation or to prevent recurrence after surgery. The initial dose is 30 to 60 mg of prednisone or prednisolone per day. After the condition stabilizes, the dose is gradually reduced to the minimum effective maintenance dose for at least 3 months. Some people have achieved good results by using a combination of hormones and azathioprine, but the effectiveness of radiotherapy is still uncertain.

2. Surgery

Although fibrosis itself rarely requires surgical resection, once extensive fibrosis has developed, hormone therapy is rarely effective. When pressure on an organ affects its function, surgery is required. A single bilateral ureterolysis can be performed, where the ureter is wrapped with the greater omentum and moved to the outside, which can provide better and lasting relief. The recurrence rate of simple release is high.

In the late stage, for severe urinary tract obstruction, percutaneous nephrostomy drainage can be performed. This method is better than retrograde ureteral catheterization or support surgery. It can not only relieve symptoms in time, but also monitor renal function through urine electrolyte measurements, allowing most patients to avoid hemodialysis.

From the above information, we know that the early stage of treatment of idiopathic retroperitoneal fibrosis generally uses glucocorticoids. The tumor can be seen to shrink in a few weeks. For the elderly or those with other diseases, pine drugs are used for treatment. Surgery is generally used when a large amount of fibrosis occurs, such as percutaneous nephrostomy drainage, which can reduce the use of dialysis.