CLINICAL-FEATURES OF UROGENITAL TUBERCULOSIS - REPORT OF 60 CASES

Based on the results of a retrospective study of 60 patients treated b etween January 1984 and December 1994, the authors review the current clinical features of urogenital tuberculosis. The sex-ratio shows a ma le predominance of 65%. The mean age is 48 years. Cystitis and low bac k pain are the main symptoms of the disease. IVU, performed in all pat ients, showed pathological images in 98.3% of cases. Urine culture was positive in 23 out of the 50 cases in which it was performed. Serious forms were relatively frequent, with bilateral lesions in 12 cases, a ssociated with renal failure in 4 of them, or unilateral renal destruc tion in 43 cases. All patients were treated with triple- or quadruple- agent tuberculostatic therapy. 54 patients required one or several sur gical procedures: 43 nephrectomies, 7 ureterovesical reimplantations, 11 augmentation enterocystoplasties, 1 Bricker ureteroileostomy, 3 ure terostomies, 1 ureteric resection and 4 epididymectomies. Two patients admitted in a context of deterioration of the general state died duri ng the days following admission. 56 patients were reviewed with a mini mum follow-up of 6 months. Two were cured by medical treatment alone. Among the 54 operated patients, clinical improvement was obtained in 4 3 patients (91%) and radiological improvement was obtained in 33 of th e 36 cases in which IVU was performed (91%). In conclusion, despite th e various anti-tuberculosis campaigns, urogenital tuberculosis remains a serious disease, essentially because of the delayed diagnosis.