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In contrast, the majority of retroperitoneal fibrosis is classified into idiopathic retroperitoneal fibrosis, for which immunological etiology has been suggested. Recently, idiopathic retroperitoneal fibrosis has been considered to be a spectrum of immunoglobulin\u00a0G4\u2010related disease, a systemic inflammatory disease, the concept of which has been developed during the past decade. In the management of retroperitoneal fibrosis, assessment of systemic lesions associated with immunoglobulin\u00a0G4\u2010related disease and the exclusion of secondary retroperitoneal fibrosis is mandatory. Histological examination of retroperitoneal lesions is desired for accurate diagnosis and management. Laparoscopic or open biopsy is often beneficial, although it is more invasive than needle biopsy. Treatment for idiopathic retroperitoneal fibrosis consists of meticulous glucocorticoid therapy based on that for immunoglobulin\u00a0G4\u2010related disease, which is expected to be highly effective. Ureteral obstruction is usually managed with conservative procedures, such as ureteral stenting or percutaneous nephrostomy. The goal of treatment for retroperitoneal fibrosis should be freedom from the stent\/nephrostomy with withdrawal of the glucocorticoid in addition to salvage of renal function; however, conservative management does not always provide favorable outcomes. In contrast, aggressive surgical treatment, such as ureterolysis, can achieve the goal; however, the procedure is associated with high morbidity. Establishment of a consensus about treatment for idiopathic retroperitoneal fibrosis, including the optimal indications for the invasive surgical procedure and conservative management, is desired.<\/jats:p>","DOI":"10.1111\/iju.14218","type":"journal-article","created":{"date-parts":[[2020,3,13]],"date-time":"2020-03-13T01:59:16Z","timestamp":1584064756000},"page":"387-394","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["Current approach to diagnosis and management of retroperitoneal fibrosis"],"prefix":"10.1111","volume":"27","author":[{"given":"Toshiaki","family":"Tanaka","sequence":"first","affiliation":[{"name":"Department of Urology Sapporo Medical University Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoya","family":"Masumori","sequence":"additional","affiliation":[{"name":"Department of Urology Sapporo Medical University Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,3,12]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"1104","volume-title":"Campbell\u2010Walsh Urology","author":"Nakada SY","year":"2016"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68035-5"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ki.5002427"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2015101110"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e3181b72882"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0b013e318289610f"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185X.12863"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11739-016-1599-z"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756287214565637"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.5114\/reum.2016.63667"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.13915"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.revmed.2014.10.008"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12094-018-1936-y"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000011842"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2012.07.015"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0b013e3181afc420"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-015-3022-y"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-010-1580-6"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16100-X"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.7326\/M13-2648"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e3181342f0d"},{"key":"e_1_2_11_23_1","first-page":"23","article-title":"Retroperitoneal fibrosis. 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