Clinical Analysis Of 186 Cases With Renal Tuberculosis

Objective:To analyze the manifestations, treatment and prognosis of our patients diagnosed with renal tuberculosis in recent 5 years, which would be helpful to improve our diagnosis method and treatment plan.Methods:186 cases of renal tuberculosis from 2010 to December 2012 were selected, of whom,91 male and 95 female, age from 13 to year, average age is 39.8 years.100 cases (53.76%) were under 40 years old. The history, clinical symptoms, body involvement, urine bacteria, IVU, Ultrasound test, CT, treatment and prognosis of these patients were analyzed.Results:From 2010 to December 2014,83 cases (44.62%) of renal tuberculosis had previous lung tuberculosis history or abnormal inchest X-ray, the clinical symptom include frequent micturition (126 cases), urgency micturition (108 cases), dysuria (98 cases), hematuria (65 cases), low back pain (78 cases), fever (45 cases), while,11 cases had no obvious symptom. In all of these patients,99 cases had typical symptom while the other 87 cases were not.97 patients were found urinary tract tuberculosis, contralateral hydronephrosis were found in 11 cases, serious unilateral renal dysfunction were found in 96 cases,6 patients were found combination with reproductive system tuberculosis, further more, bladder contracture were found in 3 cases, secondary urethral tuberculosis were found in 1 case. Routine urine sediment bacteria detection were made in 35 patients, while only 9 cases were positive. IVU examination were performed in 161 patients, while 73 cases can be diagnosed. B ultrasound examination were performed in 123 cases,50 cases could be definitely diagnosed.133 cases in 175 were diagnosed with CT examination. In all of these patients,46 cases were treated with medicine,33 were cured, and the other 153 were treated by operation.144 patients were treated by short term course control followed by unilateral nephrectomy and patial ureterectomy,85 case were cured.9 patients underwent partial nephrectomy, all of which were cured by medicine after the operation. One of three bladder contracture was reconstructed by sigmoid cystoplasty. In all of these patients, there was no death case.Conclusion:In recent years, because of antibiotic abuse, antibiotic resistance lead to atypical renal tuberculosis increased slightly, mainly happened in patient between 20 to 40 years old. The main clinical symptom were frequent micturition, urgent micturition and painful micturition, mine bacteria examination, It’s very helpful to test the Urinary acid-fast bacilli, Ultrasonography, IVU, urine routine examination and to learn the history. CT has a high accuracy rate. The patients of the early renal tuberculosis confined to the lower pole or upper pole does not supports radical nephrectomy. Laparoscopic nephrectomy for the advanced renal tuberculosis is recommended.