Urinary tract tuberculosis: A 10-year experience

Ninety-seven patients with urinary tract tuberculosis were reviewed from January 1983 to December 1993 at our hospital. Aside from two cases of miliary tuberculosis and three cases with coexisting active pulmonary tuberculosis, most urinary tract infections developed from a previous primary lung infection. Patients usually exhibited local symptoms. Fever, weight loss and anorexia were uncommon. Eighty-nine percent of the patients had abnormal urinalysis (hematuria and/or pyuria). Eight percent of the patients also had genital involvement, whereas 38% of these patients had normal intravenous pyelogram and urinalysis. Pyelograms disclosed abnormalities in 94% of the 97 patients and most revealed late changes, which were correlated with higher incidence of azotemia and anemia noted at diagnosis. Chemotherapy is the mainstay of treatment and at least three antituberculous drugs are required for initial therapy due to high drug resistant rate. Reconstructive surgery is warranted to salvage renal function. Except 6 patients run into maintenance hemodialysis, the renal functions of all patients remained stable during the period of follow-up, either receiving chemotherapy alone or combined surgery. Renal calcification may not represent inactive process, which requires further evaluation.