Retroperitoneal fibrosis (Ormond’s disease) occurs when scar-like tissue develops in the retroperitoneum. The condition can affect your urinary system, kidneys and more. It can cause life-threatening complications. But when caught early, most people make a full recovery.
Your peritoneum is a layer of tissue that protects most of the organs in your abdomen. The retroperitoneum is a space behind your abdominal cavity.
It includes your:
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Retroperitoneal fibrosis is a rare form of retroperitoneal disease that causes scar-like tissue (fibrosis) over organs in the retroperitoneum. As a progressive disorder, symptoms like pain and low urine output worsen over time.
As fibrosis progresses, it affects the organs and structures in the retroperitoneum. It often affects the ureters, which transport urine from your kidneys to your bladder. In advanced cases, fibrosis may cause life-threatening complications, including kidney failure.
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The condition often occurs in men between 40 and 60 years old.
Other factors that increase your risk include:
The cause is often unknown (idiopathic). Other times, it’s a complication of:
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Drugs such as:
Symptoms vary based on the location of fibrosis and how advanced it is. In the early stages, you may experience pain in your abdomen, lower back or sides. The pain may be general, making it difficult to pinpoint its precise location.
Other symptoms include:
Advanced retroperitoneal fibrosis causes complications that include:
Your assessment may include:
Healthcare providers often diagnose retroperitoneal fibrosis using blood tests and imaging studies. A biopsy may be necessary under certain situations, including:
The therapies that are best for you depend on the location and severity of the fibrosis.
In the early stages of Ormond’s disease, your care may include:
Other treatments for advanced fibrosis are:
Because the condition often happens for no known reason, it’s difficult to prevent. But it’s a known complication of certain medications, especially if you’re taking them long-term. If you’re on these drugs, your healthcare provider will keep a careful watch for fibrosis symptoms.
If you need surgery, the procedure may include wrapping a layer of fat around the ureter. This makes it difficult for fibrosis to come back.
You may feel better after a few weeks of corticosteroids or medication management. If you need immunomodulators, stents or surgery, recovery will take longer.
Many people make a full recovery. The best chances of successful treatment come with early detection. But fibrosis can come back months or years after treatment.
People with mild cases need ongoing monitoring to check for signs of recurrence.
In the days following surgery, healthcare providers will check for signs of hydronephrosis. This complication occurs when your body releases urine that had been accumulating in your kidneys.
When your body releases the trapped urine, it can cause:
A note from Cleveland Clinic
Retroperitoneal fibrosis, also called Ormond's disease, causes scar-like tissue in the back of the abdomen. People taking certain medications have a higher risk of this disease. If you've been diagnosed with Ormond's disease, talk to your provider about any questions or concerns you have. They're there to help you.
Last reviewed on 05/20/2022.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy