A CLINICAL STUDY ON CHEMOTHERAPY FOR URINARY TUBERCULOSIS, WITH SPECIAL REFERENCE TO COMBINED TREATMENT WITH ADRENOCORTICAL STEROIDS
1965 Volume 56 Issue 10 Pages 1043-1092
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1965 Volume 56 Issue 10 Pages 1043-1092
The effect of combined administration of corticosteroids in the long-term chemotherapy (SM, PAS and INH) for urinary tuberculosis was investigated in 53 patients. The results were as follows:
(1) Influence of combined administration of corticosteroids on healing processes of renal tuberculosis was investigated on 18 nephrectomized specimens. The findings were compared with those of the control group (8 cases), in which triple drug chemotherapy was not combined with corticosteroids. Pathological examination of the specimens revealed that the healing processes were not promoted, but rather retarded by the combination of corticosteroids.
(2) In 9 cases corticosteroids were administered for 14 to 89 days in the initial stage of long-term chemotherapy in order to investigate the clinical effects. The results were beneficial in all cases except a case in which ureteral obstruction of minor degree had developed after chemotherapy of 2 years and 4 months. In the control group (15 cases), in which chemotherapy was not combined with corticosteroids, two patients had been performed nephrectomy due to deterioration of renal function.
(3) The effect on tuberculous cystitis was remarkable. Improvement in vesical symptoms and signs had been achieved in shorter periods than in the control.
(4) In 3 cases in which combined administration was done in association with ureteroplasty for ureteral stenosis the beneficial results were verified from follow-up studies.
(5) No side-effects were experienced in every course of the long-term chemotherapy combined with corticosteroids.
These results indicated that the combination of corticosteroids in long-term anti-tuberculous chemotherapy for urinary tuberculosis was effective in improvement of tuberculous cystitis and in prevention of secondary complications and that corticosteroids should be used as a supplemental drug of chemotherapy in selected cases.
