泌尿生殖道结核.pptVIP

Treatment 4 Surgical management Nephrectomy Partial nephrectomy Epididymectomy Reconstructive surgery Ureteral stricture Augmentation cystoplasty Prognosis Tuberculois of The Genitourinary Tract Hongshun Ma Department of Urology Tianjin First Central Hospital Tubercle bacilli may invade one or more of the organs of genitourinary tract and cause a chronic granulomatous infection that shows the same characteristic as TB in other organs. 60% of patients are between the age of 20-60.A little more common in males than in females Etiology Mycobacterium tuberculosis Lungs--hematogenous--Genitourinary Organs Kidney and prostate--- primary sites of TB infection Pathogenesis Pathology 1 Kidney Ureter The tubercle bacilli hits the renal cortex. Pathological TB. Clinical TB. TB granulomatous Casceation (cheesy Material), Calcification Pelvis, calyces, and ureter--- thickend, ulceration Hydronephrosis Autonephrectomy “golf hole” (gaping) Pathogenesis Pathology 2 Bladder The mucosa may be inflamed. Tubercles Ulcerate Fibrosed and Contracted Ureteral refluxor Stenosis Pathogenesis Pathology 3 Prostate Seminal Vesicles Epidydimis and Testis Clinical Findings 1 Chronic cystitis refuses to respond to therapy. Pyuria without bacteria. Hematuria A nontender, enlarged epidydimis A chronic draining scrotal sinus Induration or nodulation of prostate and thickening seminal vesicles Clinical Findings 2 Symptoms Vesical irritabillity: burning, frequency, urgency, nocturia, hematuria. Flank pain: dull ache or colic Painless swelling of the epididymis or chronic draining sinus. Nonspecific complaints: persistent fever, night sweats. Clinical Findings 3 Signs Enlargement or tenderness of kidney. External genitalla Pros