[Urogenital tuberculosis. 80 cases]

Urogenital tuberculosis raises major diagnostic problems due to the frequently atypical and misleading clinical features. It is a serious disease as the lesions are often multifocal and extensive, requiring major surgical resection and urinary tract reconstruction. Prevention of this disease is based on generalization of BCG immunization and adequate treatment of pulmonary tuberculosis. Between 1985 and 1995, 80 patients with urogenital tuberculosis were treated in our department. These patients consisted of 50 males (62.5%) and 30 females (37.5%) with a mean age of 38 years (range: 20 to 50 years). IVU revealed silent kidney in 26% of cases, ureterohydronephrosis in 36% of cases, small bladder in 17% of cases, and was normal in only 5% of cases. Renal function was impaired in 32% of patients. The diagnosis was confirmed by a positive test for AFB in the urine in 64% of cases, bladder biopsy in 20% of cases and pathological examination of the operative specimen in 20% of cases. Treatment consisted of temporary urinary diversion (32%), antituberculous chemotherapy in all patients, and corticosteroid therapy in 8.7% of patients. Surgical treatment was required in 95% of patients: partial nephrectomy (2.5%), nephrectomy (50%), enterocystoplasty (18%), ileoureteroplasty (5%), ureteric reimplantation (12.5%), ureterocaliceal anastomosis (1.2%).