[Urogenital tuberculosis: problems of present-day diagnosis and treatment]

The analysis of 4904 cases with tuberculosis admitted to the urological department of Moscow tuberculosis hospital N 7 in 1996-2002 showed increased incidence of new-onset and recurrent urogenital tuberculosis--the share has risen from 2.1 to 7.8%. Of 267 new cases, 49.4% had severe destructive forms. The disease manifested with chronic cystitis in 35 (13.11%), subacute orchoepidydimitis in 35 (13.11%), anatomofunctional alterations of the kidneys (hydronephrotic transformation, non-functioning kidney, ureteritis, etc.) in 76 (28.46%) patients. Bacterial discharge occurred in 52% of new cases. The diagnosis was based on clinical and x-ray data in 48%. Isolated genital tuberculosis, isolated nephrotuberculosis and their combination were revealed in 14.23, 59.57 and 26.2% patients, respectively. Among the patients with advanced destructive forms 75% got disabled completely. This fact indicates the importance of early diagnosis and adequate etiotropic therapy. Active urogenital tuberculosis was treated surgically in 51% patients, most of the operations were made for marked destructive processes in the kidneys. The organ-removing operations were conducted in 73% of them. Preoperative tuberculostatic therapy reduced frequency of postoperative complications. In early diagnosis, the organ was saved in operations in 9.38%. It is recommended to refer patients to the phthisiourologist to be examined for urogenital tuberculosis if they have long-standing urogenital infection, destructive lesions of the upper urinary tracts, calculous prostatitis.