Laparoscopic Ureterolysis for Retroperitoneal fibrosis in a young female

Background: Retroperitoneal fibrosis (RPF) is a rare condition characterized by fibroinflammatory tissue that can encase abdominal structures, most notably the ureters, leading to ureteral obstruction.The diagnosis is confirmed on imaging studies like CT or MRI due to the non-specific nature of symptoms.Surgical intervention, such as ureterolysis, is typically required when ureteral obstruction occurs.Case Report: We present the case of a 26-year-old female who was diagnosed with bilateral RPF following complaints of bilateral flank pain.She had previously undergone bilateral DJ stenting.MRI confirmed RPF with involvement of both the mid and lower ureters.A two-stage laparoscopic ureterolysis was performed due to dense desmoplastic reaction and ureteral medialization.A novel surgical technique was employed, where the ureter was mobilized anterior to the colon, with tacking sutures securing the colon to the peritoneal fold to prevent recurrence.Post-operative recovery was uneventful.Conclusion: This case demonstrates the successful use of a staged laparoscopic ureterolysis for bilateral RPF in a young female, with a novel surgical approach aimed at reducing the risk of recurrence.While long-term follow-up is essential, this technique may offer a valuable addition to the surgical management of RPF with ureteral involvement.