{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T14:59:45Z","timestamp":1777993185520,"version":"3.51.4"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,6,18]],"date-time":"2017-06-18T00:00:00Z","timestamp":1497744000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To determine the outcomes of open ureterolysis in a contemporary cohort of patients presenting with ureteric obstruction secondary to retroperitoneal fibrosis (\n                      <jats:styled-content style=\"fixed-case\">RPF<\/jats:styled-content>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>\n                      We conducted a prospective analysis of 50 patients undergoing open ureterolysis and omental wrap between January 2012 and January 2016 in a single centre, managed by a multi\u2010disciplinary\n                      <jats:styled-content style=\"fixed-case\">RPF<\/jats:styled-content>\n                      team. Patients had a minimum follow\u2010up of 1 year. Indications were: nephrostomy\u2010dependent drainage (\n                      <jats:italic>n<\/jats:italic>\n                      = 5); stent failure as evidenced by persistent hydronephrosis (\n                      <jats:italic>n<\/jats:italic>\n                      = 20); severe stent symptoms (\n                      <jats:italic>n<\/jats:italic>\n                      = 22); and patient choice\/pre\u2010emptive (\n                      <jats:italic>n<\/jats:italic>\n                      = 3). Outcome measures were stent\u2010free rate; change in renal function post\u2010ureterolysis; operating variables (operating time, blood loss, complications, length of hospital stay); and need for further intervention.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 50 patients, 48 (96%) were stent\u2010free at 3 months and 47\/50 (94%) were stent\u2010free at 12 months. The median (interquartile range [\n                      <jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>\n                      ]) changes in glomerular filtration rate, according to these indication groups, at 1 year were: overall +6 (\u22124 to +22)% (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.05); stent failure +25 (+5 to +27)% (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001); stent symptoms +0 (\u221217 to +6)% (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.834); nephrostomy\u2010dependent drainage \u221210 (\u221219 to \u22122)% (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.731); and pre\u2010emptive 0 (0 to +8)% (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.5). A total of 11\/50 patients (22%) underwent additional procedures: nephrectomy,\n                      <jats:italic>n<\/jats:italic>\n                      = 7; uretero\u2010ureterostomy,\n                      <jats:italic>n<\/jats:italic>\n                      = 1; aneurysm repair,\n                      <jats:italic>n<\/jats:italic>\n                      = 1; 1 Boari flap,\n                      <jats:italic>n<\/jats:italic>\n                      = 1; and ureteric re\u2010implant,\n                      <jats:italic>n<\/jats:italic>\n                      = 1. Serious complications (Clavien\n                      <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content>\n                      or\n                      <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content>\n                      ) occurred in 12% of patients. The median (\n                      <jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>\n                      ) blood loss was 390 (20\u20131,200) mL and the median (\n                      <jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>\n                      ) length of hospital stay was 8 (3\u201321) days.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      This study suggests that for patients with ureteric obstruction caused by\n                      <jats:styled-content style=\"fixed-case\">RPF<\/jats:styled-content>\n                      , contemporary ureterolysis performed by a high\u2010volume specialist team can successfully render patients stent\u2010 or nephrostomy\u2010free without compromising renal function. The results suggest that ureterolysis should be considered in all patients who present with ureteric obstruction caused by\n                      <jats:styled-content style=\"fixed-case\">RPF<\/jats:styled-content>\n                      that does not respond quickly to standard treatment.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.13915","type":"journal-article","created":{"date-parts":[[2017,5,14]],"date-time":"2017-05-14T06:07:09Z","timestamp":1494742029000},"page":"556-561","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Contemporary role of ureterolysis in retroperitoneal fibrosis: treatment of last resort or first intent? An analysis of 50 cases"],"prefix":"10.1111","volume":"120","author":[{"given":"Tim","family":"O'Brien","sequence":"first","affiliation":[{"name":"Urology Centre Guy's &amp; St Thomas\u2019 NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4836-7835","authenticated-orcid":false,"given":"Archie","family":"Fernando","sequence":"additional","affiliation":[{"name":"Urology Centre Guy's &amp; St Thomas\u2019 NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,6,18]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"511","article-title":"Retention renale par periureterite. 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