1/10. Recent changes in the assessment of urogenital tuberculosis.The urogenital tuberculosis has undergone a change in form and clinical assessment. The absolute proportion of urogenital tuberculosis cases has fallen off sharply since 1967. The nmber of surgical interventions is also remarkably reduced. The cases exhibiting a milder stage have significantly increased, while the severe cases have decreased. This change of tuberculosis has made a conservative therapy favorable; therefore the current operative indication is somewhat different than 15 years ago. The time of release from the stationary treatment depends first on the animal experiment and bacterial findings; furthermore, tests are necessary to determine the status of immunity. It was revealed with urogenital tuberculosis, through regular examination of the menstrual blood of women, that the number of positive cases among women was considerably higher, than among men. In contracted bladder a surgical intervention is often necessary due to intense pain and incontinence. We prefer the rectal bladder with sigmoid pull-through inside the sphincter ani, whereby excellent success can be achieved. The study shows that the clinical assessment of tuberculosis is somewhat different today than is was earlier. tuberculosis underwent a change in form that must be taken into consideration with respect to operative indication.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
2/10. Urogenital infection by mycobacterium bovis relapsing after 50 years.A 64-year-old man was referred to chest clinic after presenting initially with painless haematuria. Bladder biopsies showed granulomatous inflammation and subsequent urine cultures grew mycobacterium bovis. He had been treated empirically for genito-urinary tuberculosis twice previously and on both occasions his haematuria ceased. Although the early hospital notes have been destroyed we believe this represents a very late and recurrent relapse of cystitis due to M. bovis.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
3/10. Tuberculous epididymitis: a case report and literature review.Tuberculous epididymitis is a rare urological disease difficult to diagnose. The conventional methods for diagnosis are often time-consuming and invasive. The combined use of scrotal magnetic resonance imaging (MRI) and urinary polymerase chain reaction (PCR)-based assay for mycobacterial dna (the latter because of its high sensitivity and specificity to demonstrate mycobacterial dna) is a valuable method for rapid diagnosis of tuberculous epididymitis. We report a 79-year-old man who was admitted with the chief complaints of bilateral scrotal swelling and pain. The combined use of scrotal MRI and urinary PCR allowed prompt diagnosis of tuberculous epididymitis and adequate antituberculous therapy.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
4/10. Diagnosis and conservative treatment of tubercular rectoprostatic fistula.OBJECTIVE: To present our experience with three cases of rectoprostatic fistula with special emphasis on diagnosis and conservative management.patients AND methods: Three middle-aged men presented to us differently. All had spontaneous rectoprostatic fistulas. biopsy showed tuberculosis though three consecutive urine samples for acid-fast bacilli were negative. None of the patients were immunocompromised. Their upper tracts were normal and all had a past history of pulmonary tuberculosis. They were started on antitubercular drugs and urinary diversion with or without faecal diversion. RESULTS: All fistulae healed completely within 6 weeks of starting antitubercular treatment. One patient healed with bladder neck stenosis that required bladder neck incision. Voiding was normal on 1-year follow-up. CONCLUSION: Spontaneous tubercular rectoprostatic fistulae are rare. There should be a strong clinical suspicion in endemic areas. Prostatic biopsy proves the diagnosis. Conservative management with antitubercular drugs and urinary diversion with or without faecal diversion has a high success rate and should be the first line of treatment even if urine is negative for acid-fast bacilli.- - - - - - - - - - ranking = 0.55161156414243keywords = area (Clic here for more details about this article) |
5/10. laparoscopy-assisted ileal ureter creation for multiple tuberculous strictures: report of two cases.We describe in detail the technique of laparoscopy-assisted ileal ureter creation for multiple tuberculous ureteral strictures in two patients. The proximal anastomosis included an ileocalicostomy in the first patient and an ileopyelostomy in the second patient. The first patient had bowel entrapment behind the mesentery of the ileal loop, but the second patient had an uneventful postoperative recovery. Short-term follow-up showed good patency of the ileal loop. The variations in the technique that can cause postoperative problems are discussed, and the future of this technique is postulated.- - - - - - - - - - ranking = 13287.912839744keywords = behind (Clic here for more details about this article) |
6/10. Primary tuberculosis of the glans penis in male kidney transplant recipients: a report on two cases.An extremely rare form of genitourinary tract tuberculosis (TB) is TB of the glans penis. Here, we report on two men with TB of the glans, both occurring secondary to their wives having genital TB. To the best of our knowledge, this is the first report of this nature from iran. One case is a 48 year-old blind male with an asymptomatic papulo-pustular eruption over the glans and, the other is a 51 year-old male who had kidney transplantation in March 2004, and was referred to our transplantation clinic nine months later with papulonecrotic ulcer on the glans which did not respond to antibiotic therapy. Both patients responded well to anti-TB treatment. Our cases suggest that every papulonecrotic lesion on the glans must raise the suspicion of TB, and an underlying active or healed focus of TB should be thoroughly searched. Also, it is very important, particularly in endemic areas, that prior to transplanting a male patient, his female partner must be examined for TB of the genitalia.- - - - - - - - - - ranking = 0.55161156414243keywords = area (Clic here for more details about this article) |
7/10. Lymphangitic ureteral metastases from prostatic carcinoma.Apart from an occasional focal lesion, ureteral metastases diagnosed during life are rare. We have encountered, on intravenous urography and retrograde pyelography, a rather characteristic appearance of multiple undulating areas of narrowing produced by diffuse lymphatic involvement of the periureteral fat in occult prostatic carcinoma with normal regional lymph nodes. Over a 10-year period, six such patients were reviewed. Four patients presented with colicky pain and three proceeded rapidly to either azotemia or acute anuria. A fifth patient with vague symptoms were into acute anuria. In three patients the prostate gland felt benign, but four-corner biopsies of the prostate disclosed the occult malignancy. The serum acid phosphatase was normal in two patients and only slightly elevated in four. In addition to ureteral lymphangitic involvement, five of the six patients had bone or lung involvement. All areas responded well to orchidectomy and estrogen therapy. The survival time was surprisingly good with two patients alive and well after 5 years.- - - - - - - - - - ranking = 2.1032231282849keywords = pain, area (Clic here for more details about this article) |
8/10. Concomitant ceco-appendicular and urinary tuberculosis. Description of two rare cases: physiopathological and diagnostic remarks.Two cases of specific tubercular processes in the ceco-appendicular zone and the urinary system in men aged 25 and 30 years are described. Both patients reported abdominal pain and persistent fever that did not respond to treatment. Surgery revealed ulcerated appendix, intraperitoneal serous exudate, ascitic liquid, peritoneal ulcerocaseous nodules, and fibrous adhesions. Histological sections revealed a tubercular puchet in the ceco-appendicular zone. Subsequent x-ray test in response to reports of frequent painful urination showed specific lesions in the papillae and renal ureteral ampullae, and urine cultures were positive for Koch's bacillus. Treatment with streptomycin, followed by isoniazid, rifampicin, ethambutol, and morinamid for 2 years, was effective.- - - - - - - - - - ranking = 2keywords = pain (Clic here for more details about this article) |
9/10. Genitourinary tuberculosis: the importance of early diagnosis and management. Case presentation.Genitourinary tuberculosis is the second most common form of extrathoracic tuberculosis. The most common signs are persistent sterile pyuria in up to 90% of patients, irritative voiding symptoms and painless hematuria in up to 80% of the patients. In puerto rico the incidence of tuberculosis is rising, being 9.2 per 100000 population in 1992. A.I.D.S. has had a steady rise since 1983. With the rise in the incidence of both diseases and with the influx immigrants from countries were tuberculosis is endemic we should expect a rise in the number of cases of genitourinary tuberculosis. Chemotherapy is the mainstay of treatment. Surgery is performed less often. Early recognition and management is important to avoid irreversible damage to the genitourinary tract. The cases of a 43 y/o man and a 30 y/o male with A.I.D.S. are discussed.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
10/10. Tubercular cavity behind the prostate and bladder: an unusual presentation of genitourinary tuberculosis.Genitourinary tuberculosis, which is still common in developing countries, sometimes has an unusual presentation. We report 2 cases of a tubercular cavity behind the bladder and prostate which initially eluded diagnosis, and discuss pathogenesis and management of this rare entity.- - - - - - - - - - ranking = 66439.564198721keywords = behind (Clic here for more details about this article) |
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