[Retroperitoneal fibrosis. Apropos of 12 cases. Retrospective study]

Twelve patients with idiopathic retroperitoneal fibrosis, between 1973 and 1988 are reviewed. Their mean age at presentation was 41 years. The different and particularly confusing clinical manifestations (ejaculation disorders, pelvic or abdominal or abdominal mass) are discussed. The diagnosis, which was based on pyelography and retrograde pyelography, is now established much more clearly by means of ultrasound examination and CT scan. In case of diagnostic problems, ultrasound or scan guided fine needle biopsy can direct the diagnosis. However, the definitive diagnosis can only be determined by means of surgical exploration and biopsies, which were necessary in four cases. Surgical exploration was followed by surgical ureterolysis in two cases. In four cases, treatment was with corticosteroid therapy only. Five patients were treated by ureterolysis and steroid therapy. Spontaneous remission after biopsy in one case and ureterolysis alone in an another case has been followed by CT scan with a mean follow-up of 24 months. Results were satisfactory in 20 on 22 ureters treated by corticotherapy alone, surgery alone or both operation and steroid treatment with a mean follow-up of 56 months.