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Urinary tract tuberculosis: a 10-year experience

S C Kao1, J T Fang, C J Tsai

  • 1Department of Internal Medicine Chang Gung Memorial Hospital, Taipei, Taiwan, ROC.

Changgeng Yi Xue Za Zhi
|March 1, 1996
PubMed
Summary
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Urinary tract tuberculosis often stems from prior lung infections, presenting with local symptoms and abnormal urinalysis. Prompt chemotherapy and surgery are crucial for preserving renal function.

Area of Science:

  • Nephrology
  • Pulmonology
  • Infectious Diseases

Background:

  • Urinary tract tuberculosis (UTTB) is a significant extrapulmonary manifestation of tuberculosis.
  • Most UTTB cases originate from a resolved primary lung infection, often presenting with localized symptoms rather than systemic signs.
  • Early diagnosis and management are critical to prevent renal damage.

Purpose of the Study:

  • To review the clinical characteristics, diagnostic findings, and treatment outcomes of patients with urinary tract tuberculosis.
  • To evaluate the efficacy of chemotherapy and surgery in managing UTTB and preserving renal function.
  • To highlight the correlation between diagnostic findings and patient prognosis.

Main Methods:

  • Retrospective review of 97 patients diagnosed with urinary tract tuberculosis between January 1983 and December 1993.

Related Experiment Videos

  • Analysis of clinical symptoms, urinalysis, intravenous pyelogram (IVP) findings, and treatment regimens.
  • Assessment of renal function and patient outcomes during follow-up, including those requiring hemodialysis.

    • Main Results:

    • Most patients (excluding military TB and coexisting pulmonary TB) had UTTB secondary to previous lung infection, with predominant local symptoms.
    • Abnormal urinalysis (hematuria/pyuria) was observed in 89% of patients; IVP revealed abnormalities in 94%, often showing late changes.
    • Chemotherapy with at least three antituberculous drugs is essential due to high resistance rates; reconstructive surgery aids in salvaging renal function.

    Conclusions:

    • Urinary tract tuberculosis requires aggressive treatment with multi-drug chemotherapy and potentially surgery to maintain renal function.
    • Abnormal IVP findings, particularly late changes, correlate with azotemia and anemia, emphasizing the need for timely intervention.
    • Renal calcification in UTTB may not indicate inactivity and warrants further investigation.