[Asynchronous bilateral hydronephrosis in retroperitoneal fibrosis with an interval of 44 months]

The case of a man, now aged 53 years, with bilateral, asynchronous (44 months apart) hydronephrosis caused by retroperitoneal fibrosis is reported. A review of the literature with reference to the reported side effects of H2-antagonists (which the patient had taken immediately before developing the hydronephrosis) does not reveal any definite relation between the disease and these drugs. Stenosis and medialization of the middle third of the ureter (mostly bilateral) should suggest retroperitoneal fibrosis to the urologist, as early surgical treatment is mandatory to preserve renal function. Postoperatively, immunosuppression for at least 6 months is highly recommended to prevent recurrence.