Genitourinary Tuberculosis : Experiences Over a Period of 16 Years

One hundred sixty tour patients with genitourinary tuberculosis who were seen in the department of Urology of Ewha Womans University Hospital over the 16-year period 1976~1991 were studied. The author analyzed patient's clinical. radiological and laboratory dates.

The following results were obtained :

1) The number of admissions under the impression of genitoruinary tuberculosis were 203 which was 4.2% of total number of admissions. In 1970th, it took more than 5%, but in late 1980th. it took less than 3%.

2) The age of patients varied from 11 to 67 and the mean age was 38.8. The patients at ages between 20 and 40 took 70.8% of total number. The overall sex ratio male to female was 1.15:1. In patients at the age of less than 40. male was predominant by the ratio of 1.41:1, but at the ace of over 40, female was predominant by 1:1.5.

3) The frequency of involvement of kidney was the highest by 82.3% (135 case). and then followed by epididymis 14.6% (24 cases), prostate 1.8% (3 cases). Among l35 cases of renal tuberculosis. 15 cases(11.5%) occured bilaterally, and 53 cases(39.3%) and 67 cases(49.6%) occured at right side, respectively.

4) Patients who had histories of tuberculosis other than genitourinary tract were 42 cases(25.6%) ; 39 patients had pulmonary tuberculosis or tuberculous pleurisy.

5) Most of patients had more than two symptoms. The urinary frequency was the most frequent symptom, which occurred in 52 cases(31.7%) ; and hematuria. flank pain and dysuria were also commonly seen. In four cases, there were symptoms of fever andoliguria.

6) In urinalysis, 55 cases(31.7%) showed both pyuria and hematuria. and 25 cases(15.9%) showed only hematuria. Urine AFB were seen on the microscope in 58 cases.

7) We could find the mixed type of infection in 26 cases(l5.9%) on the urine culture, and E. coli was seen most frequently among these( 11 cases, 6.7%).

8) On the excretory urography, there were non-visualized kidney in 57 cases(34.8%). hydronephrosis in 59 cases(36.0%). caliectasis in 47 cases(28.7%). and associated calcification and stones in 13 cases(7.9%). and most of these were combined.

9) In 43 cases, the treatment that has been used on the patients was INH. EMB. and RFP combination therapy only ; and for 121 cases. anti-tuberculous therapy and surgery were delivered. The most commonly used method of the operation was simple nephrectomy in 71 cases(43.3%). 23 cases of tuberculous epididymitis. all have been treated with surgical method. For the ureteral stricuture caused by tuberculosis, the endourologic methods of treatment were stent indwelling in 9 cases(5.5%) and balloon dilation in 7 cases(4.3%). Each of the cystoplasty and simple cystectomy with ileal conduit for contracted bladder caused by tuberculosis was performed in each 1 case.