The Management of Urinary Tuberculosis for Preservation of Renal Function

Choi, Young Deuk; Lee, Jin Moo

Abstract

During the period 1985-1989, 101 patients of urinary tuberculosis were treated at our hospital. Fifty-one of these patients were found to have obstructive dilatation of the urinary tract on pyelography. We reviewed these cases according to treatments for preservation of renal function. Twelve of these 51 cases were managed by chemotherapy only despite of the presence of obstructive dilatation. Eighteen of 51 cases required reconstructive treatment by partial nephrectomy (2), reimplantation of ureter into bladder (3), ileocystoplasty (2) and ileal conduit urinary diversion (1). In 24 of 51 cases, endourologic procedures were performed by stent indwelling (13), ureteral dilatation (7), endopyelotomy or endoinfundibulotomy (4). Seven cases had permanently a percutaneous nephrostomy to prevent further deterioration in renal function. In the cases that were managed only medically, 3(25.0%) improved, but, in reconstructive surgeries, improvement was noted in all cases and surgical morbidity was low. In 19 endourologic cases (79.2%), there has been a substantial improvement in renal function. Thus, in order to save more kidneys from destruction by tuberculosis despite of modern drug treatment, surgical or endourologic interventions are required when scar or stricture threatens to obstruct urinary flow.