Steroid therapy for ureteral obstruction after aortoiliac graft surgery

We report 3 cases of ureteral obstruction following aortoiliac prosthetic graft surgery owing to secondary retroperitoneal fibrosis around anteriorly positioned ureters. The reversal of symptoms and radiographic demonstration of relief of obstruction after oral steroid therapy are discussed. The necessity of placing such grafts behind the ureters is reiterated and the routine performance of preoperative and postoperative excretory urography is suggested. A trial of steroid therapy following early detection of such obstruction in lieu of early surgical exploration is discussed.