A Clinical Observation on Urinary Tract Tuberculosis

Kim, Nam Kuk; Kim, Dong Han

Abstract

A clinical observation was made on 121 cases of urinary tract tuberculosis in the Department of Urology Hanyang University Hospital during the 8 year period from May, 1972 to April, 1980. The following results were obtained: 1. The incidence of urinary tract tuberculosis was 5.7% of total in-patients and the proportion of male to female was 1.7:1. 2. 34.4% were affected in the right kidney, 34.2% in the left and 31.4% in both. 3. Age and sex distribution showed that 33.9% were from 20 to 29 years old, 27.3% from 30 to 39 and 17.4% from 40 to 49. Regarding the sex, 76 cases (62.8%) were male and 45 cases (37.2%) were female. 4. Initial symptoms were mostly those of vesical irritable symptoms and hematuria (25.6%). 5. From past history 17.4% had pulmonary tuberculosis or pleurisy, 4.1% had tuberculous epididymitis, and 2.5% bone tuberculosis. 6. 25.6% of the cases visited the hospital within 1 month to 6 months after the onset of symptoms. 7. Other presenting active tuberculous lesions were pulmonary (14 cases), bony (3 cases) and lymphatic (1 case). 8. Ordinary urine cultures revealed mixed infection in 12 cases (15.2%), 4 cases of these 12 cases also had E. coli (5.1%). 9. A.F.B. was found in 67.5%. The total of all negative cases by the staining and culture method was 18.2%. 10. On cystoscopic findings 29 of 85 cases (34.1%) revealed a contracted bladder, but 5 cases (5.9%) showed normal finding. 11. Excretory urography showed calyceopelvic dilatation in 20.7% of cases, non-visualization in 19.3%, hydroureteronephrosis in 14.5%, contracted bladder in 12.4%, calcification in 7.6% and most cases had multiple changes in the kidneys. 12. Urographic findings based on the Lattimer classification showed far advanced tuberculous lesions in almost all cases. 13. Operative procedures were simple nephrectomy in 32 cases (69.6%), ureteroneocystostomy in 6.5% and ileocystoplasty with ureteroneocystostomy in 4.3% of 46 cases.