✦ Retroperitoneal Fibrosis Treatment

Ureterolysis — Open / Laparoscopic

Q: Does ureterolysis cure retroperitoneal fibrosis?

Ureterolysis relieves obstruction and protects kidney function but does not cure RPF; ongoing medical therapy with steroids or tamoxifen is required to manage the inflammatory mass.

Q: Will the fibrosis come back and re-trap the ureters?

Recurrence is possible; omental wrapping and medical therapy reduce recurrence risk; follow-up with serial imaging is essential. Your consultant will provide specific guidance based on your individual clinical situation and recovery.

Q: Is RPF always benign?

Most RPF is idiopathic (IgG4-related disease); 10–15% are caused by retroperitoneal malignancy — biopsy at ureterolysis provides essential histological diagnosis.

Surgical Freeing of the Ureters from Retroperitoneal Fibrosis

120–240 min PROCEDURE

3–6 Days HOSPITAL STAY

>80% SUCCESS RATE

4–6 Weeks RECOVERY

What is Ureterolysis — Open / Laparoscopic?

Ureterolysis is the surgical dissection and freeing of ureters that have been encased and obstructed by retroperitoneal fibrosis (RPF). The dense fibrous tissue surrounding the ureters is carefully dissected to restore ureteric mobility and drainage. Following freeing, the ureters are repositioned lateral to the fibrotic mass (lateralisation) or wrapped in omentum to prevent re-encasement. Laparoscopic ureterolysis is increasingly performed, offering equivalent success with faster recovery. The procedure is performed under general or spinal anaesthesia with a hospital stay of 3–6 Days. Success rates reach >80% in appropriately selected patients at experienced centres.

Patients with retroperitoneal fibrosis causing ureteric obstruction, hydronephrosis, and impaired renal function confirmed on CT or PET-CT imaging. Patients must be adequately fit for anaesthesia and free from active systemic infection before proceeding.

How the Procedure Works

Port / Incision Placement

Midline laparotomy or laparoscopic port placement; retroperitoneal mass identified.

Dissection & Mobilisation

Ureter identified and traced proximally; fibrotic tissue carefully dissected off the ureteric adventitia.

Bilateral Liberation

Both ureters liberated from fibrotic encasement bilaterally.

Lateralisation & Omental Wrap

Ureters lateralised to prevent re-entrapment, or omental wrap applied to protect from recurrence.

Stent Placement & Closure

DJ stents placed to maintain drainage; drains placed; wound closed.

Outcomes

120–240 minDURATION

3–6 DaysHOSPITAL STAY

>80%SUCCESS RATE

4–6 WeeksFULL RECOVERY

Who Needs This Treatment?

→Restores ureteric drainage preventing progressive renal failure.
→Provides tissue biopsy for histological diagnosis and exclusion of malignancy.
→Lateralisation and omental wrapping reduce recurrence of entrapment.
→Laparoscopic approach offers smaller incisions and faster recovery.
→Combined with medical therapy (steroids, tamoxifen) for best outcomes.
→Bilateral ureterolysis performed in same operation when required.

"Ureterolysis is technically demanding but kidney-saving surgery. By freeing the trapped ureter and wrapping it in omentum, we restore drainage and protect the kidneys from ongoing fibrotic encasement."

— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon

Common Questions

Frequently Asked

Does ureterolysis cure retroperitoneal fibrosis?+

Will the fibrosis come back and re-trap the ureters?+

Is RPF always benign?+

Not sure which treatment is right for you?

Book a consultation with Dr. Vipin Reddy and get a personalised treatment plan.

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