Reconstructive bladder surgery in genitourinary tuberculosis

Area of Science:

• Urology
• Infectious Diseases
• Surgical Oncology

Background:

• Genitourinary tuberculosis (GUTB) affects 15-20% of pulmonary tuberculosis cases.
• Reconstructive surgery is necessary for GUTB with severe anatomical distortion unresponsive to chemotherapy.
• Augmentation cystoplasty aims to increase bladder capacity while preserving native bladder tissue.

Purpose of the Study:

• To review various bladder reconstruction options for genitourinary tuberculosis.
• To discuss indications and complications associated with different reconstructive procedures.

Main Methods:

• Review of reconstructive procedures for urinary bladder in GUTB management.
• Discussion of augmentation cystoplasty using various bowel segments (stomach, ileum, sigmoid colon).
• Analysis of orthotopic neobladder reconstruction for specific GUTB cases.

Main Results:

• Ileocystoplasty, colocystoplasty, and gastrocystoplasty are discussed with specific indications.
• Orthotopic neobladder is a feasible option for tubercular thimble bladder.
• Choice of reconstruction depends on surgeon's skill and patient's condition, considering factors like reflux and blood supply.

Conclusions:

• Multiple bladder reconstruction techniques exist for GUTB, each with unique benefits and drawbacks.
• The selection of a specific technique is tailored to individual patient needs and anatomical considerations.
• Understanding indications and potential complications is crucial for successful surgical management of GUTB.