Persistent Tuberculous Cystitis: The Most Common Indication for
Nephrectomy in the Management of Urogenital Tuberculosis

Skutil, V; Obsitník, M

doi:10.1159/000472737

Cited by 3 publications

(1 citation statement)

References 10 publications

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“…Corticosteroids as adjuvant therapy are useful for overcoming bladder contraction [10]. Skutil and Obstnik [19] recommended early nephrectomy for persistent tuberculous cystitis.…”

Section: Operative Managementmentioning

confidence: 99%

Indications for Surgical Management of Genitourinary Tuberculosis

Carl

Stark

1997

World j. surg.

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The incidence of tuberculosis has risen in many parts of the world, and more attention is being focused on genitourinary tuberculosis (GT), the second most common extrathoracic form of tuberculosis. Although chemotherapy is the mainstay of treatment, ablative surgery as a first-line management may be unavoidable for sepsis or abscesses. In cases with hydronephrosis and progressive renal insufficiency caused by obstruction, renal drainage (by stenting or nephrostomy) must be performed immediately. In all other situations triple-drug chemotherapy should be undertaken for at least 6 months and stable conversion obtained before ablative or reconstructive surgery is planned. Nephrectomy or partial nephrectomy is indicated for nonfunctioning or poorly functioning kidneys, particularly if continuous flank pain or hypertension is present. Stenosis of the ureter usually can be managed by temporary stenting and adjuvant corticosteroid therapy. Today the indications for augmentation are rare, but bladder replacement may be combined with ureter replacement using segments of intestine.

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“…Corticosteroids as adjuvant therapy are useful for overcoming bladder contraction [10]. Skutil and Obstnik [19] recommended early nephrectomy for persistent tuberculous cystitis.…”

Section: Operative Managementmentioning

confidence: 99%

Indications for Surgical Management of Genitourinary Tuberculosis

Carl

Stark

1997

World j. surg.

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Urogenitaltuberkulose

Lenk¹,

Rothenberger²,

Brühl³

1999

Urogenitale Infektionen

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Surgical and endoscopic therapy

Rossétti

Terrone

1998

Urologia

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Despite the efficacy of new chemotherapy regimens, the medical treatment of genitourinary tubercolosis leads to recovery without sequelae in only 17–47% of cases. Open or endoscopic surgery therefore maintains an important role in treatment of the disease. Eighty years ago nephrectomy was the treatment of choice of renal tubercolosis. Nowadays some authors limit nephrectomy to patients with intractable pain, uncontrollable secondary infections, life-threatening hematuria, uncontrollable hypertension or resistance of the mycobacterium to medical therapy. We believe nephrectomy should be performed in cases of extensive renal damage, with or without complete functional loss, and in any case should be associated with exeresis of the whole ureter. In the presence of localised lesions, such as infundibular scarring with closed-off calyx, we generally perform a calycectomy in order to avoid a relapse of the disease and other possible complications. Also in these cases, however, surgery is controversial. Another aspect under debate concerns the association between chemotherapy and steroids. These stenoses, often involving the ureter, can be treated endoscopically (placement of ureteral stent, balloon dilatation, ureterotomy) or surgically (pyeloplasty, ureteral reimplantation, ileal ureter replacement, renal auto-transplantation). A serious consequence of urogenital tuberculosis is the loss of bladder capacity. This condition may be effectively treated with cytoplasty using an intestinal segment. In conclusion, conservative or radical surgery is still necessary to treat many cases of urogenital tubercolosis.

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Persistent Tuberculous Cystitis: The Most Common Indication for Nephrectomy in the Management of Urogenital Tuberculosis

Cited by 3 publications

References 10 publications

Indications for Surgical Management of Genitourinary Tuberculosis

Indications for Surgical Management of Genitourinary Tuberculosis

Urogenitaltuberkulose

Surgical and endoscopic therapy

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