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某中心近10年泌尿生殖系统结核的临床特征

Clinical Characteristics of Genitourinary Tuberculosis during a Recent 10-Year Period in One Center.

作者信息

Lee Joo Yong, Park Hee Young, Park Sung Yul, Lee Seung Wook, Moon Hong Sang, Kim Yong Tae, Lee Tchun Yong, Park Hae Young

机构信息

Department of Urology, Hanyang University College of Medicine, Seoul, Korea.

出版信息

Korean J Urol. 2011 Mar;52(3):200-5. doi: 10.4111/kju.2011.52.3.200. Epub 2011 Mar 18.

Abstract

PURPOSE

This study was conducted to analyze the clinical characteristics and treatments of patients with genitourinary tuberculosis (GUTB) over the past 10 years.

MATERIALS AND METHODS

The study population comprised 101 patients who were diagnosed with GUTB and hospitalized from January 2000 to December 2009. Acid-fast bacilli (AFB) smear, urine tuberculosis culture, urine tuberculosis polymerase chain reaction (PCR), intravenous urography, cystoscopy, and histopathologic findings were used for patient selection. Yearly proportion, gender, patient distribution according to age, history of tuberculosis, and presence of other organ tuberculosis were analyzed.

RESULTS

The patients hospitalized with GUTB counted for 0.9% of all patients admitted to the department of urology. The sex ratio was 1:1.53 (male:female), and the patients' mean age was 45.57±12.55 years (range, 19-81 years). Among the patients, there was one immunocompromised patient. A total of 22 patients (21.8%) had a medical history of tuberculosis, mostly pulmonary tuberculosis (90.9%). The sensitivity of AFB stain, tuberculosis culture, and PCR was 41.6%, 55.4%, 33.7%, respectively. A total of 54 patients required additional surgical treatment: 30 cases of nephrectomy, 8 cases of epididymectomy, 8 cases of ureteral stent, 5 cases of nephrostomy, 1 case of ureterectomy, 1 case of augmentation cystoplasty, and 1 case of transurethral resection of prostate.

CONCLUSIONS

The frequency of GUTB tended to decrease progressively. However, GUTB is still a threat to public health. There was no previous history of tuberculosis in two-thirds of the cases of GUTB and more than half of them required further surgical treatment.

摘要

目的

本研究旨在分析过去10年泌尿生殖系统结核(GUTB)患者的临床特征及治疗情况。

材料与方法

研究对象为2000年1月至2009年12月期间确诊为GUTB并住院的101例患者。通过抗酸杆菌(AFB)涂片、尿结核培养、尿结核聚合酶链反应(PCR)、静脉肾盂造影、膀胱镜检查及组织病理学检查结果进行患者筛选。分析年度比例、性别、患者年龄分布、结核病史及其他器官结核的存在情况。

结果

因GUTB住院的患者占泌尿外科所有住院患者的0.9%。男女比例为1:1.53(男:女),患者平均年龄为45.57±12.55岁(范围19 - 81岁)。患者中有1例免疫功能低下患者。共有22例患者(21.8%)有结核病史,其中大部分为肺结核(90.9%)。AFB染色、结核培养及PCR的敏感性分别为41.6%、55.4%、33.7%。共有54例患者需要额外的手术治疗:30例行肾切除术,8例行附睾切除术,8例行输尿管支架置入术,5例行肾造瘘术,1例行输尿管切除术,1例行膀胱扩大成形术,1例行经尿道前列腺切除术。

结论

GUTB的发病率呈逐渐下降趋势。然而,GUTB仍然对公众健康构成威胁。三分之二的GUTB病例既往无结核病史,其中半数以上需要进一步手术治疗。

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