泌尿生殖道结核ppt课件

Prognosis
Pathogenesis & Pathology 2
Bladder The mucosa may be inflamed. Tubercles Ulcerate Fibrosed and Contracted Ureteral refluxor Stenosis
Pathogenesis & Pathology 3
Chest film Plain film of abdomen Excretory urograms:
1) “moth-eaten” 2) obliteration of calyces 3) dilatation of calyces 4) abscess cavities 5) ureteral strictures, shortening and straightening 6) absence of functional kidney Retrograde urography
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
chronic draining sinus. Nonspecific complaints: persistent fever,
night sweats.
源自文库
Clinical Findings 3
Signs Enlargement or tenderness of kidney. External genitalla Prostate
Nonspecific epididymitis Renal stones Urologic tumor
Complications
Perinephric abscess Renal stones Hydronephrosis Uremia
Treatment 1
Antituberculosis drugs
organs.
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)
Laboratory Findings
Persistent pyuria Tubercle bacilli cultures Blood count Erythrocyte sedimentation rate Renal function Tuberculin test
Imaging 1
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
Treatment 2
Chemotherapy 1
Treatment 3
Chemotherapy 2
Treatment 4
Surgical management Nephrectomy Partial nephrectomy Epididymectomy
Reconstructive surgery Ureteral stricture Augmentation cystoplasty
Imaging 2
Ultrasonography CT MRI
Instrumental examination
Cystoscopy “golf-hole” Biopsy
Differential diagnosis
Chronic nonspecific cystitis and pyelonephritis
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