Retroperitoneal Fibrosis Follow-up

Updated: Sep 02, 2021
  • Author: Chandra Shekhar Biyani, MS, MBBS, DUrol, FRCS(Urol), FEBU; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Further Outpatient Care

Biochemical markers (eg, C-reactive protein, erythrocyte sedimentation rate, renal function) should be monitored every 4-8 weeks to assess the response.

Radiologic assessment (eg, CT scanning, MRI) is performed every 3 months. Once disease is stabilized, scanning can be repeated at 6 months.

Recurrence of stenosis has been reported as late as 10 years; thus, long-term follow-up is necessary.

Patients with renal failure should be referred to a nephrologist early in the course of their disease and have continued nephrologic follow-up. Renal recovery is usually observed within the first 2 weeks, but some patients may not regain renal function until much later.


Further Inpatient Care

After relief of long-standing obstruction, a physiologic diuresis is expected. This is usually a self-limiting process and can be managed conservatively with fluid and electrolyte replacement.

Urea diuresis is the most common. It is self-limiting, lasting 24-48 hours. Monitoring of fluid balance and electrolytes is required. Unless otherwise contraindicated, increased oral fluid intake should suffice.

Sodium diuresis is the second most common postobstructive diuresis. It usually is self-limiting but may have a longer duration (>72 h). Monitor fluid balance and electrolytes more aggressively (ie, intake and output [I/O], central venous pressure [CVP], urine and serum electrolytes).

Ultrasonography may be used to assess hydronephrosis.



See the list below:



The natural history of retroperitoneal fibrosis (RPF) has not been clearly established. However, the outcome of nonmalignant retroperitoneal fibrosis is generally good. [72, 73, 74, 75, 76, 77, 78, 79] Renal recovery is usually observed within the first 2 weeks. Checking these patients periodically is always better because some patients may regain renal function much later. The prognosis of malignant retroperitoneal fibrosis is poor.


Patient Education

Patients with renal failure should be educated about the following:

  • The importance of compliance with secondary preventative measures

  • Natural disease progression

  • Prescribed medications (highlighting their potential benefits and adverse effects)

  • Diet