Early symptoms of retroperitoneal fibrosis (RPF) RPF are insidious. The main manifestations are nonspecific back pain, abdominal pain, and hypochondriac pain, which are persistent and dull or vague, and can develop at any age or even in newborns, but are most often seen in middle-aged adults. It is twice as common in men as in women and can affect both Caucasians and Blacks. The onset is usually insidious and the duration is long, and the diagnosis is often made months or even years after the onset of some vague symptoms. Pain is the most common and usually the earliest symptom, mostly dull and uncomfortable in the lateral lower abdomen, lumbosacral region or lower abdomen. Other symptoms include anorexia, lethargy and fatigue, swelling of one or both legs, scrotal swelling or moderate fever, and occasional palpable masses in the abdomen or pelvis. The clinical manifestations in the progressive stage are often symptoms of pressure or involvement of adjacent organs, such as proximal infection or dilatation due to ureteral stenosis, which can produce pain in the lumbar or cribriform angle, frequent urination and increased nocturia; bilateral ureteral compression can lead to sudden anuria; lumbar tenderness is very common because of frequent hydronephrosis or kidney infection. Hypertension is common (one of the causes of headache), mostly due to renal obstruction, as it can return to normal with ureteral rupture, release or removal of a non-functional kidney. Gastrointestinal symptoms can be related to uremia or direct damage to the gastrointestinal tract (e.g., displaced strictures). Stenosis of the biliary and pancreatic ducts, if involving the portal or splenic veins, has been reported to cause portal hypertension with esophagogastric fundic varices and ascites. Fibrosis can also cause protein-losing enteropathy or impaired absorption due to obstruction of retroperitoneal or mesenteric lymphatic reflux. With lymphatic, venous or small arterial compression or obstruction in the retroperitoneal cavity, one or bilateral leg swelling, penile swelling or scrotal edema, or even filling or varicose abdominal wall veins, thrombosis of the lower extremities, weak pulses at the end of the lower extremities, and intermittent claudication may occur. It may be accompanied by fibrosis at other sites (e.g., mediastinal bile ducts, etc.) or even sclerosing cholangitis, Peyronie’s disease (Peyronie’s disease, stiffening of the penile corpus cavernosum, producing fibrous painful penile erection, i.e., fibrous cavernositis), etc. Hong What tests should be done for idiopathic retroperitoneal fibrosis? 1, laboratory tests often have increased blood sedimentation, varying degrees of anemia and leukocytosis, occasionally eosinophilia, protein electrophoresis alpha and λ globulin increase, urine routine examination can be normal or a small number of white blood cells, red blood cells, later stage may have uremia, so uremic patients with normal urine should pay attention to whether it is due to retroperitoneal fibrosis 2, X-ray X-ray urography can be seen on one side or bilateral ureteral displacement, the diagnostic significance of the performance is This is different from the stenosis induced by tumor or stone: the latter does not have gradual thinning but only irregular stenosis. When the digestive tract is involved, X-ray double contrast imaging can reveal segmental stenosis of the involved intestine such as duodenum. Pelvic fibrosis can cause rectal stenosis and straightening with bladder elevation in the form of tear drop. Fibrotic plaques or abnormal soft tissue masses can be detected, and enhanced scans show more intense fibrous tissue signs. MRI 4. B-mode ultrasonography PRF masses are hypoechoic or non-echoic and have no characteristic features.