Bansal Punit, Bansal Neeru
Department of Urology RG Stone and Super Speciality, Christian Medical College and Hospital, Ludhiana, Punjab, India.
Department of Chest Medicine, Christian Medical College and Hospital, Ludhiana, Punjab, India.
Urol Ann. 2015 Jan-Mar;7(1):49-52. doi: 10.4103/0974-7796.148606.
Urogenital tuberculosis (TB) is common in developing countries. We present our experience of surgically managed cases of genitourinary TB (GUTB).
We retrospectively reviewed 60 cases GUTB who underwent surgery at our center from January 2003 to January 2010. Mode of presentation, organ involvement, investigation, surgical treatment and follow-up were studied.
There were 38 males and 22 females with a mean age of 32.5 years. The most common symptom was irritative voiding symptoms. The most common organ involved was bladder in 33 cases, and next most common was kidney in 30 cases. Preoperative bacteriologic diagnosis was confirmed in only 19 cases. A total of 66 procedures were performed as some patients needed more than one procedure. These included 35 ablative procedures and 31 reconstructive procedures. All the patients were followed-up with renal function test (RFT) at 3, 6 and 12 months. The intravenous urography and diethylenetriamine pentaacetic acid scan were performed at 3 months when indicated. Then the patients were followed with RFT and ultrasonography 6 monthly for 3 years and then annual RFT.
Many patients of urogenital TB present late with cicatrisation sequelae. Multidrug chemotherapy with judicious surgery as and when indicated is the ideal treatment. The results of reconstructive surgery are good and should be done when possible. Rigorous and long term follow-up is necessary in patients undergoing reconstructive surgery.
泌尿生殖系统结核在发展中国家较为常见。我们介绍我们在泌尿生殖系统结核（GUTB）手术治疗病例方面的经验。
我们回顾性分析了2003年1月至2010年1月在我们中心接受手术的60例GUTB病例。研究了其临床表现方式、器官受累情况、检查、手术治疗及随访情况。
38例男性，22例女性，平均年龄32.5岁。最常见的症状是刺激性排尿症状。最常受累的器官是膀胱，共33例，其次是肾脏，共30例。术前仅19例确诊为细菌学诊断。共进行了66次手术，因为一些患者需要不止一次手术。其中包括35次切除手术和31次重建手术。所有患者在术后3个月、6个月和12个月进行肾功能检查（RFT）随访。如有需要，在3个月时进行静脉肾盂造影和二乙三胺五乙酸扫描。然后患者每6个月进行一次RFT和超声检查，持续3年，之后每年进行一次RFT。
许多泌尿生殖系统结核患者就诊时已出现瘢痕化后遗症。适时进行明智的手术并联合多药化疗是理想的治疗方法。重建手术效果良好，应尽可能进行。接受重建手术的患者需要严格且长期的随访。
