The surgical management of non-functioning tuberculous kidneys

During the last 3 years we have explored all cases of non-functioning tuberculous kidneys in patients seen at our hospital. The operative, pathological and bacteriological findings are presented. In 89.3 per cent of the cases (25 of 28) the kidneys and ureters were destroyed and nephrectomy was done. In 10.7 per cent (3 of 28 cases) a reconstructive operation was possible with gratifying results. In 17.9 per cent (5 of 28 cases) the caseous material was positive for acid-fast bacilli on direct smear. It is concluded that surgical exploration should be done on all patients with non-functioning tuberculous kidneys to, 1) salvage kidneys before they are damaged totally by the obstructive lesions, 2) remove a potential source of infection with viable organisms and 3) shorten convalescence.