Urogenitalna tuberkuloza – klinični primer

Tomaž Smrkolj, Boštjan Likar, Dejan Galič
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Abstract

Urogenital tuberculosis is uncommon in developed countries. Numerous and nonspecific urologic complaints are characteristic, e.g. lower urinary tract symptoms, haematuria, renal pain, palpable lesions in testis and epididymis and constitutional symptoms. Microbiological diagnostic tests together with imaging and endoscopy are indicated in urogenital tuberculosis. The role of surgery has changed in the era of modern antimycobacterial agents. Surgery is used in advanced stages and is reconstructive rather than ablative for removal of infected tissue. Article describes procedures for treatment of urinary obstruction, surgical procedures on kidney, ureter, bladder, prostate and urethra and testis with epididymis. Case report presents 69 year old man who presented with left side epididymitis, however after initial diagnostic tests tumour of left testis and epididymis and right kidney with liver metastasis was suspected. Computer tomography of thorax diagnosed miliary tuberculosis. Patient was transferred to pulmonary department, where tuberculosis was confirmed and medical antituberculous therapy was initiated. Adequate treatment response with regression of tuberculous lesions in urogenital tract was observed.
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泌尿生殖系统结核在发达国家并不常见。许多非特异性的泌尿系统症状是特征性的,如下尿路症状、血尿、肾痛、睾丸和附睾可触及的病变以及体质症状。泌尿生殖系统结核的微生物诊断检查应结合影像学检查和内窥镜检查。在现代抗细菌药物的时代,手术的作用发生了变化。手术用于晚期,用于重建而不是消融去除感染组织。文章介绍了治疗尿路梗阻的程序,对肾脏,输尿管,膀胱,前列腺和附睾的尿道和睾丸的手术程序。病例报告:69岁男性患者表现为左侧附睾炎,但在初步诊断检查后怀疑左侧睾丸、附睾和右侧肾脏肿瘤伴肝转移。胸部电脑断层扫描诊断为军旅结核。病人被转到肺科,在那里确诊为肺结核,并开始进行药物抗结核治疗。观察到泌尿生殖道结核性病变消退,治疗效果良好。
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CiteScore
0.30
自引率
0.00%
发文量
65
审稿时长
4-8 weeks
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