ABSTRACT
Background: Tuberculosis can affect any organ system of the body, including the genitourinary tract. Genitourinary TB is the most common form of extra pulmonary TB accounting for 27% (14- 41%) worldwide. Aim and objectives: To study distribution of GU TB in relation to age, sex, anatomical site, signs and symptoms and to study various diagnostic modalities, treatment and role of surgery in GU TB. Materials and methods: This study was a cross sectional study done at department of Urology, King George hospital, Visakhapatnam. The study was done over a period of 30 months, which was from September 2014 to February 2017. All the patients reporting to the hospital with proven genitourinary tuberculosis or diagnosed after coming to the hospital were included in the study. Total number of cases was 35. 10 were males and 25 were females. History, physical examination, laboratory and radiological investigations were done on the patients and the primary focus of the disease and organs involved are determined. All the patients received treatment as indicated. Results: Most of the patients (33 out of 35) belonged to low socio-economic status and came from rural settings. Of them 10(28.57%) were males and 25(71.43%) were females. The mean age of patients was 36 years (range 16-60years). 2 patients were <20 years, 11 patients were between 21-30 years, 11 patients were between 31-40 years, 8 patients were between 41-50 years and 3 were above 50 years. In this study, kidney was involved in 19 cases and was the most common organ involved, followed by bladder (14 cases) and ureter(10 cases). Irritative voiding symptoms were the most common symptom seen in 23 cases. Flank pain was noted in 20 cases, sterile pyuria in 22 cases and hematuria in 7 cases. Six(17.14%) out of thirty five patients had renal failure at the time of presentation and diagnosis. Nephrectomy was done in 12 cases. Nephrectomy with augmentation Immadi Chandrasekhar, Pasalapudi Anurag Jose. Clinical study and management of genitourinary tuberculosis. IAIM, 2019; 6(1): 48-57. Page 49 cystoplasty and ureteric reimplantation was done in another 6 cases. Ileal conduit was done in 6 cases. Ureteric reimplantation with psoas hitch was done in 3 cases. Conclusion: Genitourinary tuberculosis is often silent and has nonspecific clinical features. Irritative voiding symptoms are the common presentation. Kidney is the most commonly affected organ in GU TB. GU TB is a disease of young adults, with majority affected in the 3rd and 4th decades. CT scan is replacing IVU as an imaging modality of choice in GU TB. Diagnosis of GU TB can be baffling, compelling a high index of suspicion owing to paucibacillary load in the biological specimens and the difficulty to isolate or grow TB bacilli. Hence a strong clinical suspicion is necessary for correct diagnosis. Anti-tubercular therapy is the mainstay of treatment. Genitourinary tuberculosis results in sequel which may require major organ removing and reconstructive surgeries
ABSTRACT
El presente artículo es una revisión bibliográfica sobre los estudios aplicables por medio de la tecnología nuclear destacando su utilidad en los estudios gammagráficos renales. El renograma es un procedimiento que utiliza radiosótopos nefrourológicos, con la generación de curvas actividad/tiempo, para el registro, adquisición de imágenes secuenciales dinámicas del riñón y consecuentemente el análisis cualitativo y cuantitativo de la información. El propósito del presente artículo es destacar la importancia de los estudios de Medicina Nuclear aplicados a patologías Nefrourinarias. La utilidad de este procedimiento es diversa permitiendo, la identificación de alteraciones a nivel morfológico, perfusorio, funcional y excretor renal. De igual manera este tipo de procedimientos son aplicables en la evaluación de las infecciones del tracto urinario, transplante renal, función renal, detección precoz de las posibles complicaciones; estudio de la progresión de la nefropatía crónica del injerto, valoración de la respuesta al tratamiento de las crisis de rechazo, monitorización en el tratamiento y/o recuperación quirúrgica, entre otras que se mencionan a continuación detalladamente.
This article is a literature review of the applicable studies using nuclear technology highlighting its usefulness in renal scintigraphy studies. The renal scan is a method using radioisotope nephro-urological, generating curves activity/time for recording, dynamic sequential acquisition of images of the kidney and consequently the qualitative and quantitative analysis of the information. The purpose of this article is to highlight the importance of Nuclear Medicine studies applied to pathologies nephrourinary. The usefulness of this procedure is diverse allowing the identification of functional morphological alterations, perfusorio, and renal excretory. Similarly these procedures are applicable in the evaluation of urinary tract infections, kidney transplant, renal function, early detection of possible complications; study the progression of chronic allograft nephropathy, evaluation of response to treatment of rejection crises, monitoring treatment and / or surgical recovery, among others mentioned below in detail.
Subject(s)
Humans , Radionuclide Imaging/instrumentation , Diagnostic Techniques and Procedures , NephrologyABSTRACT
This study was performed to investigate the proper method for evaluating renal function in miniature pigs with unilateral ureteral obstruction. Experimental unilateral renal damage was induced after ligation of unilateral right ureter in 3 miniature pigs. On the 3rd post-operative day, scintigraphic images were obtained after 12 mCi of 99mTc-diethylentriamene pertaacetate (DTPA) intravenous injection. Renography showed that radiopharmaceutical uptakes in the right kidney were lower than those of left kidney uptakes as early as at 3 days after surgical operation. The static images of 99mTc-DTPA enabled us to measure the relative renal function in miniature pigs with unilateral ureteral obstruction. In conclusion, renography using 99mTc-DTPA was the useful diagnostic method to evaluate the renal function in miniature pigs.
Subject(s)
Injections, Intravenous , Kidney , Ligation , Radioisotope Renography , Swine , Ureter , Ureteral ObstructionABSTRACT
Since 1954. radioisotope renography has been performed as a useful kidney function test in the urological field The author using Hypaque-I which has no liver interference, performed radioisotope renography on 25 cases, in which 10 cases of normal, 5 cases of obstructive uropathy, 7 cases of renal dysfunction, 1 case of acute glomerulonephritis and 2 cases of hypertensive uropathy were included In the normal cases, the Hypaque-I renogram has 3 typical segments, namely vascular segment, functional segment and evacuation phase. The vascular segment begins 8~20 seconds after a rapid intravenous injection of Hypaque-I, lasting 30-40 seconds and occurs the functional segment. The functional segment is completed within 3~10 minuets, having a peak And then, the evacuation phase appears, inclining down rapidly. In the renogram of obstructive uropathy, the vascular and functional segments are almost normal together, but the evacuation phase is either prolonged or increased In the renogram of renal dysfunction, the vascular segment is not only reduced, but also the functional segment is low and the evacuation phase shows a dull inclining curve. In the renogram of acute glomerulonephritis, shows no changes of each segment. The renogram of hypertensive uropathy represents the remarkably lower vascular and functional segments and evacuation phase than those of renal dysfunction. The Hypaque-I renogram has many practical advantage, offering rapid and immediate results, being easily performed, being non-traumatic and innocuous, making each kidney to be tested separately, being able to be repeated frequently, and being free from any preparation and anesthesia of patients.