Joshua E. Sterling, MD, MSc, presented “Retroperitoneal Fibrosis: Turning Friendly Territory Hostile” during the 1st International Functional and Reconstructive Urology Update on August 30, 2024, in Denver, Colorado.
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How to cite: Sterling, Joshua E. “Retroperitoneal Fibrosis: Turning Friendly Territory Hostile.” August 30, 2024. Accessed Dec 2024. https://grandroundsinurology.com/retroperitoneal-fibrosis-turning-friendly-territory-hostile/
Retroperitoneal Fibrosis: Turning Friendly Territory Hostile – Summary
Joshua E. Sterling, MD, MSc, addresses the complexities and surgical challenges of managing retroperitoneal fibrosis.
In this 9-minute presentation, Dr. Sterling emphasizes the shift in treatment strategy over the years. While early management relied heavily on surgical intervention, the current approach prioritizes high-dose steroids as the cornerstone of treatment. For patients unresponsive to steroids, immunosuppressive agents or monoclonal antibodies are considered. Surgery is now reserved for refractory cases or when systemic therapy is insufficient.
Sterling includes imaging and procedure videos that illustrate the challenges of retroperitoneal fibrosis. He stresses that surgeons must rely on sharp dissection rather than electrocautery to navigate the fibrosis safely. Techniques like intraluminal ICG or cystoscopy are recommended to locate the ureter amidst dense fibrotic tissue.
Dr. Sterling concludes with practical advice on teamwork, backup planning, and the importance of coordinating surgical strategies to maintain team confidence and patient safety.
About The 1st International Functional and Reconstructive Urology Update (IFRUU)
The International Functional and Reconstructive Urology Update is a multi-day meeting focused on functional and reconstructive urology (FRU). FRU is a rapidly expanding subspecialty with the vision to improve the lives of all patients with urinary disorders. The IFRUU conference aims to equip practitioners with the tools to manage patients with functional urologic disorders effectively. The inaugural IFRUU conference took place from August 28-30, 2024 in Denver, Colorado.
For further educational activities from this conference, visit our collection page.