Management of Idiopathic Retroperitoneal Fibrosis, a Retrospective Study at Prince Hussein Urology and Organ transplantation center (PHUO), Jordan

to study the presentation, clinical course, laboratory results, imaging findings, medical and urological treatments of idiopathic retroperitoneal fibrosis at our institution. Methods. Between January 2006 and December 2017, medical records and operatives’ notes of 116 patients with idiopathic retroperitoneal fibrosis (IPRF) were reviewed retrospectively. Diagnosis was done by clinical and radiological imaging that fulfilled a strict criterion. All patients were initiated on Prednisolone 60 mg for two months, and reduced until reaching 10 mg daily, with a total duration of 24 months in the responding patients. Renal drainage was done in cases of obstructed kidneys. To assess response, both laboratory results and imaging studies at initiation and after 4 months were reviewed and compared. Results. Of 116 patients diagnosed with IRPF, eighty five (73.3%) were male and thirty one (26.7%) female, with mean ± SD age at presentation was (50.5 ± 10.6) years. 79% of the patients complaint of abdominal and low back pain, 27% uremic symptoms, 10.3% had a new onset of hypertension, 3.4% presented with anejaculation, and 13.8% were totally asymptomatic. Uretric obstruction had been resolved in 132 ureters after a mean of 152 days of treatment. Almost 30 % reduction in the fibrotic mass size was achieved in 82 % of patients. Conclusion. Glucocorticoids is the the mainstay of treatment. The renal function tests, of the vast majority of patients, normalized with treatment. Relapse may occur, so a follow-up over a long period of time is required. A high index of suspicion is needed for diagnosis in asymptomatic patients.