The Clinical Analysis Of 43 Cases Of Epididymal Tuberculosis

Objective In order to improve the level of diagnosis and treatment, the clinical features, diagnosis and therapy of epididymal tuberculosis were analyzed. Method Forty three cases of epididymal tuberculosis derived from department of urology of first affiliated hospital of Xinjiang Medical University in 1997～2007 were retrospectively studied. Those cases were analyzed respectively from clinical data(including general considerations, course of disease, onset position, clinical manifestation and physical examination),laboratory findings(including uronoscopy and others methods)and imaging features(chest x-ray findings, intravenous pyelography, ultrasonic image and computerized tomographic scanning). Results The incidence of epididymal tuberculosis were highest among age 21to 40 years old. The most frequent symptom of disease was painless lump in scrotum or swell and pain of scrotum. The proportion of complicating pulmonary tuberculosis and atypical epididymal tuberculosis were respectively 35% and 51%. The negative results of urine analysis were respectively acid-fast stains on urinary sediment of 2 patients, tubercle bacillus culture of urine and urine PCR-TB-DNA of 1 patient. The diagnose accordance rate of B-type ultrasonography, KUB+IVU and CT were respectively 38%,25%,33%. 42 patients underwent epididymidectomy and ensued anti-tuberculosis agents with 6 months. One patient treated only by anti-tuberculosis agents.16 patients who were followed up were cured. Conclusion The incidence of epididymal tuberculosis were highest among age 21 to 40 years old. Tuberculosis of epididymis was seen more in left than right side. It was difficult to diagnose the disease in early stage and needed aggregate analysis by clinical manifestation, laboratory test and imaging findinds. It was found close correlation between reproductive tuberculosis and urinary tuberculosis. So the patients who suspected catch epididymal tuberculosis should take several tests including urine analysis, acid-fast stains on urinary sediment, urine PCR-TB-DNA, intravenous pyelography, CT and so on. B-type ultrasonography and CT were helpful to diagnosis. The therapy of epididymal tuberculosis were exairesis and anti-tuberculosis agents.