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ÜRÎNER TÜBERKÜLOZLU 24 OLGUYA AÎT KLÎNÎK ÖZELLİKLER

CLINICAL FEATURES IN 24 PATIENSTS WITH URINARY TUBERCULOSIS

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Abstract (2. Language): 
In this study, clinicalfeatures in 24 patients diagnosed as urinary tuberculosis in our nephrology and urology clinics between 1993 and 2000 years were investigated retrospectively. Fourteen patients (52 %) were male and mean age was 42 (18-66) year. Twenty percent of the patients were asymptomatic. Frequency-dysuria (41%), flank pain (33%) and macroscopic hematuria (12 %) were presenting symptoms. Physical examination was not diagnostically helpful in most of patients. Hematuria and/or pyuria were detected in 87 percent of the patients. Ten patients had positive urine cultures ofM. Tuberculosis (42 %) and 6patients had positive smears (25 %). Definitive diagnosis of urinary tuberculosis was established microbiologically in 14 patients (58 %) and histopathologically in 10 patients (42 %). Hydronephrosis (majority bilateral) in 10 patients (42 %) contracted bladder in 8 cases (33%) and renal calcification in 6 cases (25 %) were detected. Two patients had also genital tuberculosis (orchiepiididymitis). While medical treatment was done in 12 patients alone for 9 months, plus medical therapy surgical intervention was also carried out in the others. End stage renal failure developed in one patient and died on hemodialysis. Renal functions had decreased moderately in other two patients. In conclusion, the diagnosis of urinary tuberculosis was able to established after the obstructive complications and functional losses were developed in afair number of cases. Surgical treatment was carried out in half of patients. Urinary tuberculosis should take into consideration, since early diagnosis and treatment is very important for presenting of irreversible sequalae.
Abstract (Original Language): 
1993-2000 yılları arasında hastanemiz Nefroloji ve Üroloji kliniklerinde üriner tüberküloz tanısıyla takip edilen 24 hastaya ait klinik özellikler retrospektif olarak incelendi. Hastaların 14ü (%58) erkek olup, yaş ortalaması 42 (18-66) yıl idi. Olguların %20'si asemptomatik iken; pollakiüri-disüri (%42), yan ağrısı (%33) ve makroskopik hematüri (%12) önde gelen semptonlardı. Hastaların çoğunda fizik muayene normaldi. Olguların %87'de hematüri ve/veya piyüri mevcuttu. Altı olguda idrarda ARB pozitif iken (%25), 10 olguda kültürde M. Tüberkülozis tesbit edildi (%42). Kesin tanı 14 olguda mikrobiyolojik yöntemlerle (%58), 10 olguda ise histopatolojik olarak (%42) kondu. On hastada hidronefroz (%42), 8 hastada kontrakte mesane (%33), 6 hastada ise renalkansifikasyon (%25) tesbit edildi. İki vakada aynı zamanda genital tüberkülozis (orşiepididimit) mevcuttu. Oniki hastaya 9 ay süreyle sadece medikal tedavi (%50) uygulanırken, diğer 12 olguya ilaveten cerrahi tedavi uygulandı. Bir hastada son dönem, 2 hastada ise orta derecede böbrek yetmezliği mevcuttu. Sonuç olarak, tanı hastaların önemli bir kısmında obstrüktif komplikasyonlar ve fonksiyon kaybı geliştikten sonra konmuştur. Cerrahi tedavi uygulanan hasta sayısı oldukça fazladır. Bu yüzden üriner tüberküloz gözardı edilmemelidir. Zira erken tanı ve tedavi irreverzibl sekelleri önlemek için çok önemlidir.
FULL TEXT (PDF): 
218-222

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