Idiopathic retroperitoneal fibrosis--an update.

Our belief in a non-operative approach to the management of RPF hinges on the differential diagnosis; the closer the approach to the certainty in establishing the diagnosis, the less is the risk of error in medical treatment. Careful history taking and intelligent use of the available range of investigations should allow near certainty in diagnostic accuracy and thus the progression to non-operative management in most patients. The cause of RPF remains obscure, further research into the possibility of an auto-immune reaction, perhaps a response to some factor introduced in the latter half of this century would seem to offer most prospect of success.