1978 Volume 69 Issue 8 Pages 1028-1034
Two hundred eleven patients with urogenital tuberculosis first treated from 1963 to 1972 were followed through 1975.
Of the 211 patients, 198 had active tuberculosis. They were treated for 2 years by triple drug regimen. Most patients had SM 1 g twice a week, INH 0.3g per day and PAS 10 g per day. When the side effects occurred or the bacilli were resistant to the drug, the drug was replaced with another one. Of 165 patients with active renal tuberculosis, 96 had nephrectomy and 11 had nephro-or uretero-cutaneostomy. Of 49 patients with male genital tuberculosis, 37 had epididymectomy.
As for the long-term results of treatment for active urinary tuberculosis, only 2 patients in whom the diseased kidney was not removed showed recurrence of tuberculosis bacilluria after the completion of 2 years chemotherapy. Persistent microscopic pyuria was found in 2 patients (2%) when the diseased kidney was removed, while it was found in 6 patients (9%) when the diseased kidney was conserved excluding the patients with urinary diversion. Ureteral stricture occurred as sequelae of the chemotherapy in 6 patients out of 70 in whom the diseased kidney was conserved. Pyelocalyceal morphology on IVP was improved in 34 kidneys, unchanged in 56 and aggravated in 6. Minor calyceal changes tended to heal, while advanced changes were mostly unchanged.
Long-term results of the treatment of male genital tuberculosis were satisfactory. However, obstructive azoospermia was found in 12 patients.
No serious side effect was noted during the chemotherapy. The eighth nerve impairment including slight one was recognized in 27 out of 148 patients who had SM or KM.
Thirteen patients underwent nephro-or uretero-cutaneostomy because of obstructive renal failure. Of 13 patients, 7 had colocystoplasty after the completion of chemotherapy and 6 have been unable to abandon the urinary diversion. The patients with urinary diversion have become progressively azotemic. One patient with chronic renal failure due to sequela of renal tuberculosis underwent renal transplantation and died of chronic rejection 2 years and 7 months after the operation. Ureteroplasty in the period of chemotherapy was performed in 2 patients and was followed by formation of urinary fistula or recurrence of ureteral stricture. Ureteroplasty in 6 patients and colocystoplasty in 12 patients performed after the completion of chemotherapy showed satisfactory results.
