[BASIC CONCEPTS AND CLINICAL MANIFESTATIONS OF UROGENITAL TUBERCULOSIS].

Based on analysis of domestic and international literature and his own long-standing experience the author gives clear-cut and unequivocal definitions ofdifferent forms ofurogenital tuberculosis, its comprehensive classification, which allows guiding a patient management.

Urogenital tuberculosis: patient classification in seven different groups according to clinical and radiological presentation.

PURPOSE: To describe and classify 80 cases of urogenital tuberculosis in seven groups of similar clinical and radiological presentation. MATERIALS AND METHODS: 80 patients (56 males, 70%; median age 34 years; age range 12 to 75) with urogenital tuberculosis were retrospectively reviewed. The patients were divided in seven groups: 1) Bilateral parenchymatous renal lesions; 2) No or minimal changes on radiographic examination; 3) Unilateral renal tuberculosis; 4) Contracted bladder; 5) Contracted bladder with renal failure; 6) Tuberculosis on a transplanted kidney; 7) Isolated genital tuberculosis. RESULTS: 1) Seven (8.8%) patients had multiple bilateral parenchymatous renal lesions with fever and malaise, characteristic of miliary tuberculosis. Three of these patients had AIDS. 2) Six (7.5%) cases had an early diagnosis, with minimal or no radiographic lesions. Two did not have any urologic symptoms. 3) Twelve (15%) patients had unilateral renal tuberculosis with partial (1 case) or total non-function kidney. 4) Thirty-seven (46.3%) patients had contracted bladder associated with unilateral partial (1 case) or total non-function kidney. 5) Ten (12.5%) patients had end stage renal disease due to tuberculosis with contracted bladder. 6) Four (5.0%) patients had tuberculosis on a transplanted kidney, with graft loss in half the cases. 7) Four (5.0%) patients had prostate or epididymis tuberculosis without associated renal lesion. CONCLUSIONS: Urogenital tuberculosis is a destructive disease of the urogenital tract with variable clinical and radiographic presentation. A classification according to similar patterns correlating with disease stage is feasible although early diagnosis is the only prevention of the most severe forms.

Urogenital tuberculosis: patient classification in seven different groups according to clinical and radiological presentation

PURPOSE: To describe and classify 80 cases of urogenital tuberculosis in seven groups of similar clinical and radiological presentation. MATERIALS AND METHODS: 80 patients (56 males, 70 percent; median age 34 years; age range 12 to 75) with urogenital tuberculosis were retrospectively reviewed. The patients were divided in seven groups: 1) Bilateral parenchymatous renal lesions; 2) No or minimal changes on radiographic examination; 3) Unilateral renal tuberculosis; 4) Contracted bladder; 5) Contracted bladder with renal failure; 6) Tuberculosis on a transplanted kidney; 7) Isolated genital tuberculosis. RESULTS: 1) Seven (8.8 percent) patients had multiple bilateral parenchymatous renal lesions with fever and malaise, characteristic of miliary tuberculosis. Three of these patients had AIDS. 2) Six (7.5 percent) cases had an early diagnosis, with minimal or no radiographic lesions. Two did not have any urologic symptoms. 3) Twelve (15 percent) patients had unilateral renal tuberculosis with partial (1 case) or total non-function kidney. 4) Thirty-seven (46.3 percent) patients had contracted bladder associated with unilateral partial (1 case) or total non-function kidney. 5) Ten (12.5 percent) patients had end stage renal disease due to tuberculosis with contracted bladder. 6) Four (5.0 percent) patients had tuberculosis on a transplanted kidney, with graft loss in half the cases. 7) Four (5.0 percent) patients had prostate or epididymis tuberculosis without associated renal lesion. CONCLUSIONS: Urogenital tuberculosis is a destructive disease of the urogenital tract with variable clinical and radiographic presentation. A classification according to similar patterns correlating with disease stage is feasible although early diagnosis is the only prevention of the most severe forms.

Lesiones evolutivas de la tuberculosis urogenital: correlaciones microbiológicas, anátomo-clínicas, radiológicas y ecográficas / Progressive lesions of genitourinary tuberculosis: microbiologic, anatomical clinic, radiologic and echographic correlations

La tuberculosis urogenital constituye una manifestación local de una infección generalizada. El riñón es el primer órgano urinario afectado generalmente por diseminación errática de un foco pulmonar inicial. Si la tuberculosis urogenital no es diagnosticada y tratada a tiempo se producen lesiones evolutivas crónicas, que se describen en este artículo de revisión donde se destacan sus aspectos microbiológicos, anatomoclínicos e imagenológicos (AU)

Lesiones evolutivas de la tuberculosis urogenital: correlaciones microbiológicas, anátomo-clínicas, radiológicas y ecográficas / Progressive lesions of genitourinary tuberculosis: microbiologic, anatomical clinic, radiologic and echographic correlations

La tuberculosis urogenital constituye una manifestación local de una infección generalizada. El riñón es el primer órgano urinario afectado generalmente por diseminación errática de un foco pulmonar inicial. Si la tuberculosis urogenital no es diagnosticada y tratada a tiempo se producen lesiones evolutivas crónicas, que se describen en este artículo de revisión donde se destacan sus aspectos microbiológicos, anatomoclínicos e imagenológicos

[A clinical observation on urogenital tuberculosis].

A clinical observation was made on 25 cases of urogenital tuberculosis experienced at the urological department of Chiba Prefectural Sawara Hospital between January 1973 and December 1982. They accounted for 0.28% of the 8,945 outpatients. There were 17 cases of urinary tuberculosis and 13 cases of genital tuberculosis. In urinary tuberculosis, the age distribution showed a peak in the fifties. There was a predominance in males. The patients in their twenties and fifties comprised 60% of the cases of genital tuberculosis. The kidney affected was predominantly the left kidney. Bladder tuberculosis was found in 7 cases. The majority of the epididymal tuberculosis were found in the right side. Bladder and renal symptoms were the chief complaints for 41.2% and 17.6%, of the cases, respectively. Thirty two percent of the patients had a history of tuberculosis. In cystoscopy, typical findings of tuberculosis were found in only 25% of the cases. Mycobacterium in urine could be detected in 33.3%. Accelerated blood sedimentation rate was detected in 65% of the cases. Pyelography revealed ureteral abnormality in the majority of the cases. Three of the 16 patients with renal tuberculosis underwent nephrectomy, and orchiectomy was performed on 6 of the 13 patients with epididymal tuberculosis.