[Choice of surgical correction of urodynamics in ureteral tuberculosis]

To determine an optimal choice of surgical correction of urodynamic disorders and time of its conduction in ureteral tuberculosis, we made a retrospective analysis of 271 case histories of primary patients with tuberculosis of the kidneys who had x-ray picture of ureteral lesions, hydro- or ureterohydronephrosis. We used the following methods of this correction: calycoureteroanastomosis (n = 7, 2.5%), plastic reconstruction of the pelvoureteral segment (n = 9, 3.3%), ureteroureterostomy (n = 6, 2.2%), ureterocystostomy (n = 125, 46.1%), ureteroileoplasty (n = 6, 2.2%), ureteroileocystoplasty (n = 12, 4.4%), intestinal cystoplasty with ureteral transplantation (n = 86, 31.7%). Three-four months was an optimal preoperative preparation (treatment with antituberculous drugs). Long-term administration of the drugs (up to 1 year and longer) and late surgical urodynamic correction leads to complete dysfunction of the kidney which may result in removal of this organ (35%). Palliative operations (cystostomy, nephrostomy, ureterostomy, ureterocutanestomy) often invalidate the patients and degrade quality of their life (n = 20, 7.4%). Only high qualification of the surgeon in reconstructive plastic surgery provides good results of medical rehabilitation.