Idiopathic retroperitoneal fibrosis causing ureteral obstruction is a relatively uncommon clinical entity. The various etiological theories have not satisfied all cases. Thirty-four previously recorded cases are here reviewed and a new case is added. The disease is more common in males and usually bilateral. It presents no characteristic clinical picture. Diagnosis is suggested by urographic findings but confirmed only at surgical exploration. Preoperative exclusion of other possible causes of ureteral obstruction is usually impossible. In the present case, that of a 44-year-old woman, the ureter was dissected free and its function restored; after that the entire fibrotic mass was excised, although this has not generally been found possible or necessary. Best results have been obtained by ureterolysis, preceded by nephrostomy in selected cases.
Howard B. Simon, Kaare K. Nygaard. Ureteral Obstruction Due to Idiopathic Retroperitoneal FibrosisReport of One Case and Collective Review of Thirty-four Additional Cases. JAMA. 1960;174(12):1569–1573. doi:10.1001/jama.1960.03030120009002