Tembély A, Fongoro S, Diallo D, Timbiné E, Arama C, Ouattara K
Service d’urologie, Centre hospitalier universitaire du Point G, Bamako, Mali.
Mali Med. 2008;23(3):23-31.
To specify the clinical, paraclinic and therapeutic aspects of urogenital tuberculosis in the services of Urology and Nephrology of the CHU of the Point G.
From January 2005 to November 2006, six patients reached of urogenital tuberculosis were seen. The initial evaluation comprised an interrogation in the search of antecedents of urinary extra tuberculosis, a creatinemy, a urogenital echography and an intravenous urography. The research of the bacillus of Koch in the urines was made. A bacteriological examination cyto- of urines (ECBU) was carried out as well as the histological analysis of the fragment S biological and/or the part of exérèse.
The incidence of urogenital tuberculosis was 0.3%. compared to the consulted patients. The principal clinical demonstrations were the lumbar pain (83.33%), the hématurie (33.33%), the pollakiurie (33.33%) and the burns mictionnell be (16.67%). 50% of the patients presented a fever and 33.33% an asthenia. Three (50%) were presented with a renal insufficiency (average creatinemy: 866.7 micromol/l). The bacilluria was present in 50% of the cases. Echography had shown anomalies in 100% of the cases of which most frequent was the urétéro hydronéphrose (2 cases, are 33.33%). The positive diagnosis was related to the bacteriological data (3 times) and histological (3 times). The treatment consisted of a bacillar anti chemotherapy among all patients in association with the surgery (4 cases) and/or of the endo-urologic operations (1 case).
The diagnosis of urogenital tuberculosis remains difficult and often late in our context. A surgical or endo-urologic gesture is often necessary to preserve the renal function and to improve the quality of life.
明确在点G大学医院泌尿外科和肾内科就诊的泌尿生殖系统结核的临床、副临床和治疗方面的情况。
2005年1月至2006年11月，共诊治6例泌尿生殖系统结核患者。初始评估包括询问有无泌尿系统外结核病史、检测肌酐、进行泌尿生殖系统超声检查和静脉尿路造影。对尿液进行结核杆菌检测。同时进行尿液细胞学细菌学检查（ECBU）以及对活检组织切片和/或切除部分进行组织学分析。
泌尿生殖系统结核的发病率为0.3%（相对于就诊患者）。主要临床症状为腰痛（83.33%）、血尿（33.33%）、尿频（33.33%）和尿痛（16.67%）。50%的患者有发热，33.33%的患者有乏力。3例（50%）出现肾功能不全（平均肌酐：866.7微摩尔/升）。50%的病例存在菌尿。超声检查显示100%的病例有异常，其中最常见的是输尿管肾积水（2例，占33.33%）。确诊与细菌学数据（3次）和组织学（3次）有关。所有患者均接受抗结核化疗，同时4例患者接受了手术，1例患者接受了腔内泌尿外科手术。
在我们的环境中，泌尿生殖系统结核的诊断仍然困难且往往较晚。为了保护肾功能和提高生活质量，手术或腔内泌尿外科手术常常是必要的。
