Clinical Presentation, Management, and Outcomes of Retroperitoneal Fibrosis: A 10-Year Single-Center Study of 24...

Background and objective Retroperitoneal fibrosis (RPF) is a rare fibro-inflammatory condition characterized by the formation of fibrous tissue in the retroperitoneal space. It can lead to ureteral obstruction and renal complications. Due to its nonspecific clinical presentation, diagnosis may be delayed. This study aimed to describe the clinical presentation, diagnostic findings, management strategies, and clinical outcomes of patients with RPF. Materials and methods We conducted a retrospective, single-center, descriptive study over 10 years, from May 2015 to May 2025, in the Department of Urology at Mohammed VI University Hospital, Oujda, Morocco. Twenty-four patients diagnosed with RPF were included. Results The cohort comprised 18 men (75%) and six women (25%), with a mean age of 54 years. The most common presenting symptom was low back pain, observed in 19 patients (79.2%), followed by weight loss in 17 patients (70.8%). Anuria was noted in three patients (12.5%). Acute renal failure was observed in 15 patients (62.5%). The diagnosis was established by CT in all patients, while biopsy was performed in five patients (20.8%). Idiopathic RPF was identified in 18 patients (75%). A history of retroperitoneal surgery was found in five patients (20.8%), and atherosclerosis was noted in one patient (4.2%). All patients underwent urinary drainage using a double-J stent and received systemic corticosteroid therapy. Renal function improved in six of the 15 patients presenting with acute renal failure (40%) after two months of treatment. Relapse occurred in four patients (16.7%) during a mean follow-up period of five years. Conclusions RPF should be considered in patients presenting with systemic symptoms and obstructive renal failure. In this case series, CT played a key role in the diagnosis, and urinary drainage combined with corticosteroid therapy was the main treatment approach. Long-term follow-up remains essential, as recurrence may occur over time.