[Epidemiology and clinical features of renal tuberculosis: 239 cases report].

OBJECTIVE

To study the changes in the status of genitourinary tuberculosis, especially in renal tuberculosis.

METHODS

In the study, 239 cases of renal tuberculosis from 2000 to 2010 were retrospectively reviewed. The patients with 3 or more than 3 kinds of common clinical manifestations of genitourinary tuberculosis were regarded as typical group (145 cases), and otherwise, as atypical group (94 cases).

RESULTS

The cases of renal tuberculosis constituted 0.89% of the urological inpatients in a duration of 11 years from 2000 to 2010. The incidence rates were higher in the 40-60 years old patients (45.61%). 48% of the patients were farmers or the unemployed. The most common clinical manifestations included frequency (151 cases), urgency (124 cases), odynuria (120 cases), flank pain (97 cases), and hematuria (76 cases). However, flank pain (34.04%) turned into the main complaint of the atypical group. We found that 125 cases had a history of pulmonary tuberculosis or an abnormal chest radiography, 30 patients were diagnosed as contracted bladder (typical group/atypical group: 26/4, P<0.05), and 20 patients (8.4%) were diagnosed as contralateral hydronephrosis. And 198 cases were examined by acid-fast stain, with a positive diagnostic rate of 47.98%. Also 202 cases of the 205 patients who had an ultrasonography had an abnormal outcome and 135 cases of them were definitively diagnosed. Surgical treatments were performed among almost all the patients, while 21 cases only had antituberculosis drugs.

CONCLUSION

Socio-economic issues still affect the status of genitourinary tuberculosis. The history of pulmonary tuberculosis or an abnormal outcome of chest radiography can provide an important clue during the diagnostic process. Acid-fast stain and ultrasonography remain as effective screening tests. Though the treatment with antituberculosis drugs has become the "mainstream", the surgical treatment is needed for advanced renal tuberculosis.