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泌尿生殖系统结核的挑战。

Challenges in urogenital tuberculosis.

机构信息

Novosibirsk Research TB Institute, Urogenital Clinic, Novosibirsk, Russian Federation.

Novosibirsk State Medical University Novosibirsk, Novosibirsk, Russian Federation.

出版信息

World J Urol. 2020 Jan;38(1):89-94. doi: 10.1007/s00345-019-02767-x. Epub 2019 Apr 17.

Abstract

PURPOSE

For better understanding of urogenital tuberculosis (UGTB), its clinical spectrum and characteristic features need to be evaluated.

MATERIALS AND METHODS

One hundred and forty-two cases of UGTB patients were analyzed retrospectively. We considered age, gender, symptoms, and diagnostic procedures.

RESULTS

The total of 142 patients were divided into group A (consisted of 93 patients with only urinary TB), group B (consisted of 13 male patients with generalized UGTB, including urinary TB and male genital TB (MGTB). Group C consisted of 36 patients with MGTB. Sixty patients in groups A and B 56.6% had kidney TB third-to-fourth stages, which are incurable for anti-TB therapy and require surgery. The urinary tract was involved in 48 patients (45.3%): 25 (23.6%) had ureteral TB and 23 (21.7%) had also bladder TB. The most common symptom for kidney TB was flank pain (69.8%) followed by dysuria (47.2%). Perineal pain and dysuria were most common symptoms for prostate TB and were found in 87.5% (14 patients) and 56.3% (9 patients), respectively. Of total, in only 58 UGTB patients (40.8%), the culture for Mycobacterium tuberculosis (Mtb) was positive.

CONCLUSION

Of 142 patients with UGTB, 106 (74.7%) had kidney TB and 13 (9.2%) of them had kidney TB in combination with MGTB. Only MGTB (prostate, scrotal, or generalized) was diagnosed in 49 (34.5%) patients. The most common symptoms were flank pain and dysuria. Identification of Mtb in UGTB is difficult. Therefore, the most advanced microbiological technology should be used to establish the correct diagnosis.

摘要

目的

为了更好地了解泌尿生殖系统结核(UGTB),需要评估其临床谱和特征。

材料与方法

回顾性分析 142 例 UGTB 患者。我们考虑了年龄、性别、症状和诊断程序。

结果

142 例患者分为 A 组(93 例仅为尿结核)、B 组(13 例男性为全身性 UGTB,包括尿结核和男性生殖系结核(MGTB))和 C 组(36 例 MGTB)。A 组和 B 组中有 60 例(56.6%)患者患有无法通过抗结核治疗治愈的肾脏 TB 第三至第四阶段,需要手术治疗。48 例患者(45.3%)有尿路受累:25 例(23.6%)有输尿管结核,23 例(21.7%)还有膀胱结核。肾脏结核最常见的症状是腰痛(69.8%),其次是尿痛(47.2%)。会阴部疼痛和尿痛是前列腺结核最常见的症状,分别见于 87.5%(14 例)和 56.3%(9 例)的患者。在总共 142 例 UGTB 患者中,58 例(40.8%)结核分枝杆菌(Mtb)培养阳性。

结论

在 142 例 UGTB 患者中,106 例(74.7%)患有肾脏结核,其中 13 例(9.2%)患有肾脏结核合并 MGTB。49 例(34.5%)患者仅患有 MGTB(前列腺、阴囊或全身性)。最常见的症状是腰痛和尿痛。在 UGTB 中识别 Mtb 很困难。因此,应使用最先进的微生物学技术来建立正确的诊断。

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