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Abstract:
Most of all cases of extrapulmonary tuberculosis i.e. 35% are urogenital tuberculosis UGT. A shifting of morbidity to older age Groups could be ascertained. 1164 cases were evaluated, 684 in a combined medicamentons - operative manner. Of the conservatively treated Group were 283 males and 197 females; the relation of the sexus in the other group is roughly the same. The frequency has a maximum in the forth decade. Whereas most of 90 patients, who have been in stationary treatment in April 1975, were between 40 and 60 years old. The pathogeny of the UGT is shown according to the scherne of Gloor. Most of the initial Symptoms (26.5%) are dysuria, the mext are hematuriae and ache of the flanks. On an average 1-2 years pass from the first appearance of symtonis to the time of diagnosis. The diagnosis can only be verified by evidence of Tbc-bacteria in cultures and biological experiments or through histological appearance. Essential informations on localisation and expansion are obtained by x-ray examination, that is urograms and urethrocystograms. Angiography and side-disconnectet isotope clearance are importantant additional examinations. According to the results of the x-ray examinations the stages can be ascertained: Stage I: parenchymal-ulcerated pattern - Stage II: ulcerated-cavernous pattern - Stage III: totally-destructing tuberculosis, tbc-pyonephrosis, Special terms characterize the obstructions of the urinary tract. For the therapy the following polity can be proposed: Stage I: chemotherapy - Stage II: chemotherapy, perhaps backed by conservative operative treatment - Stage III: chemotherapy and nephro-ureterektomy.