Symptoms and Treatment of Retroperitoneal Fibrosis

Retroperitoneal fibrosis (RPF) is a rare inflammatory disease in which the formation of abnormal fibre-like tissue occurs behind the membrane extending into the abdominal cavity.

Retroperitoneal fibrosis occurs as a result of inflammation of the fatty tissue located behind the peritoneum. As a result of the inflammation the fatty tissue degenerates and fibrotic bands form.

Symptoms of Retroperitoneal Fibrosis

People who develop retroperitoneal fibrosis generally experience weakness, eating disorder, high fever and excessive weight loss. The most frequent symptom in retroperitoneal fibrosis is back or abdominal pain. In most cases this pain is dull, vague and difficult to localise. 

The patient's complaint begins with pain in the kidneys and abdomen. Because it is a rarely encountered disease, a kidney disorder may be the first thing to come to mind during examination by a physician.

The diagnosis of RPF is made as a result of the investigations performed. If diagnosis is delayed and the disease progresses, over time the fibrotic bands that form as a result of the inflammation of the fatty tissue begin to compress and strangle anatomical structures. This causes obstruction of the ureters and the patient's inability to pass urine.

Cessation of urine output in the body causes a rapid rise in urea. The rise in urea over time obstructs the vessels going to the legs and swelling, pain and numbness occur in the legs. In addition, the disease can lead to high blood pressure in the person.

Depending on the site where the obstruction occurs, the accumulation of urine can cause the pelvis and renal channel to swell with urine (hydronephrosis). High blood pressure (hypertension) and ultimately renal (kidney) failure can also develop. Symptoms of kidney failure include nausea and vomiting.

The disease is diagnosed with the aid of computed tomography or MRI as a result of detecting the fibrotic mass that has formed in the body.

Treatment of Retroperitoneal Fibrosis

For the treatment of retroperitoneal fibrosis, the location and extent of the diseased tissue growth must first be determined. An appropriate treatment is then planned for the patient.

In advanced RPF there is also a risk of conditions such as kidney failure developing. If obstruction has occurred in the ureters because of the fibrotic mass, surgical intervention is required.

After the operation the patient needs to receive regular cortisone treatment. In some cases stents may be placed in the ureter to provide temporary relief from the obstruction.

As in every disease, early diagnosis is of great importance in retroperitoneal fibrosis too. For that reason the patient should consult their physician when they feel any pain in the kidney or abdominal region, without waiting for the other symptoms of the disease (such as loss of appetite or nausea).

Even though it is a rarely encountered disease, knowing how much risk its consequences carry is of considerable importance.