Initial experience of ileal ureter replacement combined with augmentation cystoplasty in the treatment of ureteral stenosis with contracted bladder / 中华泌尿外科杂志

Objective To explore the availability and safety of ileal ureter replacement combined with ileal augmentation cystoplasty in treating ureteral stenosis with contracted bladder.Methods From August 2015 to November 2018,three patients who underwent ileal ureter replacement combined with augmentation cystoplasty were treated with ileal ureter replacement combined with augmentation cystoplasty.There were 1 male and 2 females with the age ranging from 34 to 55 years (mean 39 years).Two patients suffered from left ureter stenosis,and one patient had stenosis on the both sides.The length of the ureter stenosis ranged from 6 to 18 cm (mean 9.8 cm).The preoperative bladder capacity ranged from 60 to 150 ml (mean 103.3 ml).In the surgery,part of ileum was used to replace the ureter,and the distal intestine was made into U-shape to enlarge the bladder.Results All operation were completed successfully.The operation time ranged from 220 to 400 min (mean 303.0 min),and the blood loss ranged from 150 to 500 ml (mean 283.3 ml).Laparoscopic surgery was performed in 1 case and open surgery in 2 cases.Three weeks after the surgery,the bladder volume underwent cystography ranged from 300 to 400 ml (mean 360.0 ml).Three months after the surgery,the postvoid residual urine volume ranged from 20 to 50 ml (mean 33.3 ml).Postoperative frequency and urgency of urine were completely relieved in 1 case,alleviated in 2 cases.Flank pain was completely relieved in 1 case,and alleviated in 2 cases postoperatively.The serum creatinine of 2 patients mildly increased after the surgery,while 1 patient remained stable.For complications,1 patient had urinary infection,and 1 patient suffered from metabolic acidosis.Conclusions Ileal ureteral replacement combined with augmentation cystoplasty can be the choice of treatment for long segment ureteral stenosis and enlarge the bladder simultaneously.The postoperative complications and the kidney functions should be regularly followed up.

Tubercular Testicular Abscess in a Young Male-Rare Presentation of a Common Disease.

Genitourinary tuberculosis is rare manifestation of extra pulmonary tuberculosis which itself is an fairly uncommon manifestation of a common global disease. Of these rare manifestations, we present a still rarer case of testicular tubercular abscess. We highlight the importance of testicular tuberculosis as a differential diagnosis of testicular mass / abscess and use of histopathology in clinching the diagnosis.

Spinal tuberculosis in an infant associated with maternal urinary tuberculosis.

Summary: A ten-month-old infant who presented with regression of milestones and seizures was noted to have a gibbus deformity in the upper thoracic region. She was diagnosed to have spine and central nervous system tuberculosis by culture of pus from the paravertebral abcess which showed a growth of Mycobacterium tuberculosis. The mother, who had been having recurrent episodes of Urinary tract infection, was diagnosed to have Urinary TB proven by culture. Spinal tuberculosis, though rare, can be encountered in infancy and should be kept in mind while treating infants presenting with related symptoms.

Antimicrobial resistance in Campylobacter spp isolated from broiler flocks / Avaliação de resultados do Teste Direto para Mycobacterium tuberculosis (MTD) e da cultura para micobacterias em amostras de urina

Tuberculosis remains a public health problem in Turkey. Rapid detection of Mycobacterium tuberculosis plays a key role in control of infection. In this article, the Gen-Probe Amplified Mycobacterium Tuberculosis Direct Test (MTD) was evaluated for detection of M. tuberculosis in urine samples. The performance of the MTD was very good and appropriate for routine laboratory diagnosis.

A tuberculose continua sendo um problema de saúde pública na Turquia. A detecção rápida de Mycobacterium tuberculosis tem um papel importante no controle da infecção. Nesse artigo, avaliou-se o Gen-Probe Amplified Mycobacterium Tuberculosis Test (MTD) para detecção de M. tuberculosis em amostras de urina. O desempenho do MTD foi muito bom e adequado para diagnóstico laboratorial de rotina.

Evaluation of the results of Mycobacterium tuberculosis direct test (MTD) and Mycobacterial culture in urine samples

Tuberculosis remains a public health problem in Turkey. Rapid detection of Mycobacterium tuberculosis plays a key role in control of infection. In this article, the Gen-Probe Amplified Mycobacterium Tuberculosis Direct Test (MTD) was evaluated for detection of M. tuberculosis in urine samples. The performance of the MTD was very good and appropriate for routine laboratory diagnosis.

A tuberculose continua sendo um problema de saúde pública na Turquia. A detecção rápida de Mycobacterium tuberculosis tem um papel importante no controle da infecção. Nesse artigo, avaliou-se o Gen-Probe Amplified Mycobacterium Tuberculosis Test (MTD) para detecção de M. tuberculosis em amostras de urina. O desempenho do MTD foi muito bom e adequado para diagnóstico laboratorial de rotina.

The Management of Urinary Tuberculosis for Preservation of Renal Function / 대한비뇨기과학회지

During the period 1985-1989, 101 patients of urinary tuberculosis were treated at our hospital. Fifty-one of these patients were found to have obstructive dilatation of the urinary tract on pyelography. We reviewed these cases according to treatments for preservation of renal function. Twelve of these 51 cases were managed by chemotherapy only despite of the presence of obstructive dilatation. Eighteen of 51 cases required reconstructive treatment by partial nephrectomy (2), reimplantation of ureter into bladder (3), ileocystoplasty (2) and ileal conduit urinary diversion (1). In 24 of 51 cases, endourologic procedures were performed by stent indwelling (13), ureteral dilatation (7), endopyelotomy or endoinfundibulotomy (4). Seven cases had permanently a percutaneous nephrostomy to prevent further deterioration in renal function. In the cases that were managed only medically, 3(25.0%) improved, but, in reconstructive surgeries, improvement was noted in all cases and surgical morbidity was low. In 19 endourologic cases (79.2%), there has been a substantial improvement in renal function. Thus, in order to save more kidneys from destruction by tuberculosis despite of modern drug treatment, surgical or endourologic interventions are required when scar or stricture threatens to obstruct urinary flow.

Clinical Observation on Urinary Tuberculosis Treated by Operation / 대한비뇨기과학회지

Two hundred four patients with urinary tuberculosis who underwent surgical intervention were evaluated during the period from 1970 to 1988. Surgical management included nephrectomy in 171 cases, nephrostomy in 35 cases, partial nephrectomy in 4 cases and reconstruction of ureteral stricture and contracted bladder in 57 cases. Of 267 cases, 3 cases of ureteral reimplantation and 6 cases of operation performed with intestinal segment were failed. For the success of operation performed with intestinal segment, creatinine lower than 2.0mg/dL was inevitable. Direct method of ureteral reimplantation were all successful but 1 case of Boari operation and 2 cases of antireflux method were failure. One case of Boari operation and 2 cases of operation performed with intestinal segment were dead. The causes of death were sepsis and acute renal failure.

Statistical Observation on Urinary Tract Tuberculosis / 대한비뇨기과학회지

144 in-patients with urinary tract tuberculosis during the period from 1965 to 1969 were observed statistically. These patients stand for 8.9% of the in-patients with male to female ratio 59.6%/40.4%. Most frequent age distribution slowed 21 to 30 years with 35.9% and next 31 to 40 years with 31.4%. And lateralization, right to left 49.3% to 41.0% and bilateral 9.7%. 47.8% of patients admitted the hospital within 6 months to 1 year after onset of symptoms, and 9.1% after 5 years. The most frequent subjective complaints was hematuria, dysuria and frequency with 41.6%, and flank pain or dullness, 30.4%. In 49.7% of cases, past history of tuberculosis was noted, of which 31.2% had pulmonary tuberculosis and 20.1% pleurisy. Tubercle bacilli were smeared positive in 49.7%. 66.7% of 102 patients showed subnormal in PSP test with criteria of 50% within 30 minutes and 70% within 2 hours. Of 113 intravenous pyelograms, functional changes revealed non-visualization 46.9%, delayed visualization 27.6%. The itemized classification based on Braasch and Emmett was similar order of frequency as original. Lattimer Grade IV and far advaced case were the most frequent in 30 retrograde pyelograms. Nephrectomy was 95% in 104 operated cases and 92 nephrectomized specimens disclosed all parenchymal tuberculous nodules, tuberculous mucosal lesion in 82%, cavities 70%, calcification 4.3%, and pyonephrosis 17%.

Clinical Statistics on Urinary Tuberculosis / 대한비뇨기과학회지

Clinical and statistical observation was made on 358 cases of renal tuberculosis seen during the period from 1954 to 1960. There patients stand for 2.72% of all the urological patients and male to female ratio 54.7%, 45.3%. lateralization, right to left 37.4% to 31.3% and bilateral 18.4%. Age distribution showed that 39.1% of the cases were in 21 to 30 years, 29.0% in 31 to 40 years and 1.1% in below 16 years of age, 24.6% of the patients consulted with the institute within six months to one year after the onset of symptoms, and 10.6% after 5 years. Of subjective complaints, hemato-pyuria, dysuria and frequency were listed in 52.2%. dysuria and frequency in 22.9%. frequency in 7.8%, hematuria in 7.5% and lumbago and flank pain in 32.7%. Bladder lesions were classified into 0. I. II. III. IV, V and VI grades after lnoue and Tada. 32.4 % of the patients showed grade III involvement, mild changes were observed in patients receiving anti-tuberculous agents and marked changes in patients receiving no anti-tuberculous agents. Lesions around the ureteral orifices were observed in 74.0% and at the base in 61.5%. In indigocarmin test, 21.6% of the cases showed excretion within 10 minutes from the diseased side and 11.2 within 5 minutes. Tubercle bacilli were smeared positive in 67.6%; 60.2% in the group treated with anti-tuberculous agents and 72.3% without treatment. In the unilateral kidney lesion, 60.8% showed advanced change and 11.1% primary lesion. Most cases of bilateral kidney tuberculosis showed marked changes. In 6.9%, advanced lesions were involved in both kidney and in 12.0% one side involved markedly and another hydronephrotic. In 32.7% of cases, past history of tuberculosis was noted, of which 63.6% had pleurisy and 22.7 % pulmonary tuberculosis. Period from previous tuberculosis to the onset of kidney tuberculosis was listed as over 10 years in 32.4% and in 23.1% between one and three years. Complications were observed in 18.7% of all cases, epididymitis in 71.8% and prostatitis in 84.2%.