Treatment of Diseased Mate Kidney in Renal Tuberculosis / 대한비뇨기과학회지

ABSTRACT

Urinary diversions were performed on 15 cases of renal tuberculosis whose mate kidneys were hydronephrotic or hydroureteric due to tuberculous involvement. Of these diversions, permanent cutaneous ureterostomy was performed on 13 cases and permanent nephrostomy on 2 cases. Irrigation through the kidney pelvis or tuberculous cavity was also performed using solutions made up with anti-tuberculous agents, streptomycin and isonicotinic acid hydrazide. Continuous gravity method and intermittent method were employed for irrigation through the indwelling catheters in the kidney pelves or through the nephrostomy tubes. The follow-up periods varied from 4 months to 51 years. The results were evaluated as follows: In 3 cases tubercle bacilli in the urine became negative within 21 days of irrigation and urinary finding improved after a short period of irrigation in 6 instances of 9 cases which showed pyuria. A marked improvement of kidney function was observed in 14 instances of 15 cases within one month after removingobstructive lesions by urinary diversions. Mild pyelonephritis and chronic urinary tract infection developed in all the cases during and after the treatment and renal failure was followed by death in 4 cases. In summary, 11 instances of 15 cases survived; excellent results were obtained in 8 instances with intubated ureterostomy in their solitary kidneys, fair results in 2 cases while one showed poor result and 4 died of uremia.