Relief of urinary tract obstruction in tuberculosis to improve renal function. Analysis of predictive factors

Ramanathan,; Kumar, Vijay; Kapoor,; Bhandari,

doi:10.1046/j.1464-410x.1998.00500.x

Cited by 41 publications

(44 citation statements)

References 19 publications

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“…4,12,[26][27][28][29] Advances in diagnostic techniques (molecular methods, etc.) and improvements in general health infrastructure hopefully will decrease this latency period.…”

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confidence: 99%

Urinary tuberculosis: a cohort of 79 adult cases

et al. 2015

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We aimed to investigate the demographic, clinical, diagnostic, treatment and outcome features of patients with urinary tuberculosis (UTB). Patients with UTB admitted to seven separate centers across Turkey between 1995 and 2013 were retrospectively evaluated. The diagnosis of UTB was made by the presence of any clinical finding plus positivity of one of the following: (1) acid-fast bacilli (AFB) in urine, (2) isolation of Mycobacterium tuberculosis, (3) polymerase chain reaction (PCR) for M. tuberculosis, (4) histopathological evidence for TB. Seventy-nine patients (49.36% male, mean age 50.1 ± 17.4 years) were included. Mean time between onset of symptoms and clinical diagnosis was 9.7 ± 8.9 months. The most common signs and symptoms were hematuria (79.7%), sterile pyuria (67.1%), dysuria (51.9%), weakness (51.9%), fever (43%) and costovertebral tenderness (38%). Cystoscopy was performed in 59 (74.6%), bladder biopsy in 18 (22.8%), kidney biopsy in 1 (1.26%) and nephrectomy in 12 (15.2%) patients. Histopathological verification of UTB was achieved in 12 (63.1%) patients who undergone biopsy and in 100% of those undergone nephrectomy. Mycobacterium tuberculosis was isolated in the urine of 50 (63.3%) cases. Four-drug standard anti-TB treatment was the preferred regimen for 87.3% of the patients. Mean treatment duration was 10.5 ± 2.7 months. Deterioration of renal function occurred in 15 (18.9%) patients two of whom progressed to end-stage renal disease and received hemodialysis. Only one patient died after 74-day medical treatment period. Cases with UTB may present with non-specific clinical features. All diagnostic studies including radiology, cyctoscopy and histopathology are of great importance to exclude UTB and prevent renal failure.

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“…4,12,[26][27][28][29] Advances in diagnostic techniques (molecular methods, etc.) and improvements in general health infrastructure hopefully will decrease this latency period.…”

mentioning

confidence: 99%

Urinary tuberculosis: a cohort of 79 adult cases

et al. 2015

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“…This occurred in 15% of our cases, with obstruction and dilatation of the collecting system, with invariable renal functional loss. In fact, obstruction of the collecting system (with distal ureteral stenosis as the most frequent in tuberculosis (11,46,47). The focal origin of tuberculosis reactivation is demonstrated by two of our cases with restriction of the disease to the renal pole.…”

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confidence: 51%

“…In only 36.6% of the cases was there history or radiographic evidence of previous tuberculosis. In cases where the renal lesions are mainly asymptomatic, and only vesical lesions lead to symptoms (7)(8)(9)(10)(11)(12)(13)(14), storage symptoms predominate. A total of 48.5% of males had scrotal involvement with an epididymis of these signs.…”

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confidence: 99%

Urogenital tuberculosis: patient classification in seven different groups according to clinical and radiological presentation

et al. 2008

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Purpose: To describe and classify 80 cases of urogenital tuberculosis in seven groups of similar clinical and radiological presentation. Materials and Methods: 80 patients (56 males, 70%; median age 34 years; age range 12 to 75) with urogenital tuberculosis were retrospectively reviewed. The patients were divided in seven groups: 1) Bilateral parenchymatous renal lesions; 2) No or minimal changes on radiographic examination; 3) Unilateral renal tuberculosis; 4) Contracted bladder; 5) Contracted bladder with renal failure; 6) Tuberculosis on a transplanted kidney; 7) Isolated genital tuberculosis. Results: 1) Seven (8.8%) patients had multiple bilateral parenchymatous renal lesions with fever and malaise, characteristic of miliary tuberculosis. Three of these patients had AIDS. 2) Six (7.5%) cases had an early diagnosis, with minimal or no radiographic lesions. Two did not have any urologic symptoms. 3) Twelve (15%) patients had unilateral renal tuberculosis with partial (1 case) or total non-function kidney. 4) Thirty-seven (46.3%) patients had contracted bladder associated with unilateral partial (1 case) or total non-function kidney. 5) Ten (12.5%) patients had end stage renal disease due to tuberculosis with contracted bladder. 6) Four (5.0%) patients had tuberculosis on a transplanted kidney, with graft loss in half the cases. 7) Four (5.0%) patients had prostate or epididymis tuberculosis without associated renal lesion. Conclusions: Urogenital tuberculosis is a destructive disease of the urogenital tract with variable clinical and radiographic is the only prevention of the most severe forms.

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“…Patients with a distal ureteric involvement, a good cortical thickness of >10 mm, a GFR of >15 ml/min seemed to have a good potential for recovery of renal function after intervention. [30]…”

Section: Management Of Renal Tuberculosismentioning

confidence: 99%

“…In such instances, it is better not to intervene, as these kidneys are less likely to improve after intervention. [30]…”

Section: Management Of Renal Tuberculosismentioning

confidence: 99%

Surgical management of renal tuberculosis

Krishnamoorthy¹,

Gopalakrishnan²

2008

Indian J Urol

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Tuberculosis (TB) is one of the major health problems that our country is facing today. Despite active interventions by our government, control of TB still remains to be achieved. The emergence and exponential growth of the human immunodeficiency virus and drug-resistant strains threaten to further complicate the TB situation in our country. Even in this era of advanced chemotherapy, many lives are lost every day in our country. Tuberculosis of the urinary tract, despite being one of the commonest forms of extra-pulmonary TB, is generally overlooked. Most patients present with vague lower urinary symptoms typical of urinary tract infection. In this article, we shall highlight the various issues related to the surgical management of renal and ureteral tuberculosis.

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Relief of urinary tract obstruction in tuberculosis to improve renal function. Analysis of predictive factors

Cited by 41 publications

References 19 publications

Urinary tuberculosis: a cohort of 79 adult cases

Urinary tuberculosis: a cohort of 79 adult cases

Urogenital tuberculosis: patient classification in seven different groups according to clinical and radiological presentation

Surgical management of renal tuberculosis

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