118 cases of orogenital tuberculosis in the south of Tunisia

The authors had for aim to study the epidemiological, clinical, therapeutic, and evolving features of urogenital tuberculosis [UGT] in the south of Tunisia. 118 patients presenting with UGT were retrospectively studied from January 1982 to December 2007 in South and Central Tunisia. The diagnosis of UGT was confirmed in all cases by clinical, biological, radiological, and/or histological data. 81 male and 37 female patients [mean age 38 years] were included. The most common presentation was storage lower urinary tract symptoms [57.6%]. General signs were observed in 25.4% of cases. The diagnosis of UGT was proven by bacteriological evidence [49.2%], positive bladder biopsy [12.7%], and pathological analysis of a surgical exeresis piece [68.6%]. The treatment was anti-bacillary chemotherapy for all patients, associated to a surgical excision [70.3%], reconstructive procedures [18.6%], and/or endoscopic manoeuvres [13.6%]. 80% of patients were regularly followed up for an average of 6 years. Favourable evolution was observed in 85.3% of cases. UGT remains a current severe disease because of the multiple risks that can result, especially for the renal function

[Genito-urinary tuberculosis inthe male, apropos of 22 cases]

An evaluation of the epidemiological, clinical, prognostic and therapeutic characteristics of male genito-urinary tuberculosis, complemented by review of the literature. We retrospectively studied 22 patients with confirmed genitor-urinary tuberculosis. The diagnosis was based on clinical, bacteriological, radiological and histological findings and radiological examination. The most common presenting symptom was chronic epididymitis [11 patients] followed by scrotal fistula [6 cases], obstructive uropathy [3 cases], hydrocele [6 cases] and infertility [1 case]. Clinical examination revealed epididymal nodules in 11 and hydrocele in 10 patients. Leucocyturia was found in one patient. Scrotal ultrasound demonstrated epididymal lesions in 8 cases. The definite diagnosis was based on histological examination of resected specimens [13 cases], biopsy specimens [8 cases] and on the discovery of the tubercle bacillus in the urine [1 case]. Intravenous urography, which was carried out routinely, detected associated urinary lesions in 5 cases. The follow-up was uneventful in all patients. The diagnosis of male isolated genitor-urinary tuberculosis is difficult in the absence of an endemic prevalence of tuberculosis. Any longstanding epididymo-orchitis should raise the suspicion of tuberculous etiology, especially in cases with hypofertility. Medical treatment has proven effective in early diagnosed cases, while surgery is reserved for resistant or complicated cases

Ampliação vesical para o tratamento de bexiga contraída por tuberculose: análise dos resultados e comparação entre as diferentes técnicas / Bladder augmentation for treatment of chronic tuberculous cystitis: analysis of the results and comparison among techniques

Foi realizada a avaliação clínica, radiológica e urodinâmica do seguimento tardio de 25 pacientes com bexiga contraída por tuberculose submetidos à ampliação vesical. Em oito casos, a ampliação foi feita com segmento ileocecal não destubulizado, em quatro com sigmóide não destubulizado e em 13 com sigmóide destubulizado. O seguimento pós-operatório médio foi de 11.1 ± 9.1 anos (1 a 36). A ampliação vesical permitiu a resolução da polaciúria e satisfação do paciente em 80 por cento dos casos. O mau resultado ocorreu na ampliação com sigmóide não destubulizado e nos pacientes com prostatite por tuberculose / Clinical, radiological and urodynamic evaluation of the late outcome of 25 patients with chronic tuberculous cystitis who underwent bladder augmentation was done. In eight cases the augmentation was made with tubularisated ileocecal segment, in four with tubularisated sigmoid and in 13 with detubularisated sigmoid. The average postoperative follow up was of 11.1 ± 9.1 years (1 to 36). The bladder augmentation solved the increased daytime frequency in 80 per cent of the patients after a long term follow-up. A poor outcome occurred in the cases using tubularized sigmoid and in the patients with prostatitis. Miccional daytime frequency of at least two hours occurred in augmented bladder with higher capacity and compliance and with normal sensation without interference of the presence of involuntary contractions...

Genitourinary tuberculosis; experience in a teaching hospital of southern Punjab

Genitourinary tuberculosis is a common accompaniment of pulmonary tuberculosis. If diagnosis and treatment are delayed, irreversible damage can result. Twenty three patients of genitourinary tuberculosis were treated at Nishtar Medical College Multan from 1992 to 1997. Mean age was 37 years. There was no typical symptom or sign. Radiological evidence of pulmonary tuberculosis was present in 11 [47%] patients. Five patients had renal failure at the time of presentation. Four patient had unilateral non functioning kidney, one patient had pyonephrosis and renal stone, six patients had unilateral stricture of ureter [2 upper, 4 lower] and one patient had bilateral stricture of ureter [lower], two patients had bladder mass, two patients had enlarged prostate, three patients had scrotal abscess, one patient had infertility and one patient had early changes. Ablative surgery was required in 5 patients while conservative and reconstructive surgery was done in 18 patients. Diagnosis of genitourinary tuberculosis requires high index of suspicion as there is no typical clinical feature. Early diagnosis is essential to avoid irreversible damage

Genitourinary tuberculosis: the importance of early diagnosis and management. Case presentation

Genitourinary tuberculosis is the second most common form of extrathoracic tuberculosis. The most common signs are persistent sterile pyuria in up to 90 of patients, irritative voiding symptoms and painless hematuria in up to 80 of the patients. In Puerto Rico the incidence of tuberculosis is rising, being 9.2 per 100000 population in 1992. A.I.D.S. has had a steady rise since 1983. With the rise in the incidence of both diseases and with the influx immigrants from countries were tuberculosis is endemic we should expect a rise in the number of cases of genitourinary tuberculosis. Chemotherapy is the mainstay of treatment. Surgery is performed less often. Early recognition and management is important to avoid irreversible damage to the genitourinary tract. The cases of a 43 y/o man and a 30 y/o male with A.I.D.S. are discussed

Tuberculosis no pulmonar: respuesta al tratamiento en condiciones del programa: experiencia del Hospital Nacional Cayetano Heredia periodo 1980 - 1990 / Non lung tuberculosis: response to the treatment proportionate by the program experiency: Hospital Nnacional Cayetano Heredia (1980 - 1990)

De 4483 casos con tuberculosis (TBC) reportados al Programa de Control de Tuberculosis (PCTBC) del Hospital Nacional Cayetano Heredia (HNCH) y centros periféricos durante el período de 1980 - 1990. 356 casos (7,9 por ciento) correspondieron a tuberculosis no pulmonar, 4036 (90 por ciento) a tuberculosis pulmonar y 91 (2,1 por ciento) a pacientes con TBC en ambas localizaciones anatómicas. Presentando un número anual de ingresos sin mayor variación. Las localizaciones anatómicas mayormente afectadas fueron: pleural 49,4 por ciento, ganglionar 18,8 por ciento, miliar 13,2 por ciento, génito-urinario, meníngea, digestivo-perítoneal y otras localizaciones en menor proporción. Hubo diferencia (p menor 0,05) entre los grupos etarios y las localizaciones anatómicas afectadas por la tuberculosis, predominando la localización meningea en menores de 14 años, miliar en menores de 25 años y génito-urinario en mayores de 35 años, dependiendo ello de la etiopatogénia de ésta enfermedad. Los pacientes con tuberculosis no pulmonar presentaron mejoría clínica al término del tratamiento médico proporcionado por el PCTBC del HNCH durante el período 1980 -1990, obteniendo una tasa de altas o éxitos de 78.3 por ciento y una tasa de fracasos 0,2 por ciento mucho menor que el obtenido en pacientes con tuberculosis pulmonar activa (8,3 por ciento), aun recibieron el 60,8 por ciento de los pacientes con tuberculosis no pulmonar esquemas terapéuticos estándar, compuesto por una droga bacteriostática en la primera fase del tratamiento

Análisis del tratamiento abreviado de la TBC genitourinaria: experiencia del Hospital de Valdivia / Analysis of short treatment of genitourinary TBC

Se analizan 120 casos de tuberculosis urogenital, diagnosticados a través de una pesquisa precoz, en el Hospital de Valdivia entre febrero de 1982 y abril de 1987. Todos fueron tratados con los esquemas abreviados TA-81 A y TA-81 B del Programa Nacional de Control de la Tuberculosis. El 88,3% de los casos tuvo confirmación bacteriológica y el 11,7% histológica. En 97 pacientes se efectuó una serie de 6 muestras de orina para estudio de Koch y en 13 se requirió más de una serie; en 32,8% la positividad se obtuvo en la 4ta., 5ta. o 6ta. muestra de la serie. Sólo 21 pacientes (18,5%) necesitaron algún tipo de cirugía, 9 de ellos nefectomía. El tratamiento fue exitoso en el 88,3%, hubo 13 fracasos y recidivas y sólo una de estas últimas persistió con cultivo de Koch positivo al finalizar el retratamiento

TBC urogenital: experiencia Hospital de Valdivia año 1979-1984 / Genitourinary TBC: experience of Hospital de Valdiva 1979-1984 years

Se presenta la experiencia en el manejo de 175 pacientes con TBC urogenital, 112 hombres y 63 mujeres, con un promedio de edad de 35,6 años. El 16,5% tiene antecedentes de un episodio de TBC anterior. Como causa de consulta destaca un 60,1% de irritación vesical, seguido de hematuria y epididimitis. El 86,8% tiene demostración bacteriológica de la enfermedad y 70 de 136 se presentan con exclusión renal radiológica unilateral al momento del diagnóstico. Todos reciben tratamiento triasociado por 18 meses con buena respuesta y tolerancia. Son intervenidos 117 pacientes, destacando como la operación más frecuente la nefrectomía total. Se controlan y son dados de alta 117 enfermos. 58 abandonan tratamiento y se desconoce su evolución. No se registra mortalidad ni recidiva durante el período de observación