[Role of supravesicular urine diversion in the treatment of patients with renal and urethral tuberculosis].

The article presents the results of the survey, etiopathogenetic and surgery treatment of 73 patients with nephrotuberculosis complicated by tuberculous ureteritis. Patients were divided into 4 groups. 1-3 Groups of patients underwent urine diversion by percutaneous puncture nephrostomy, open nephrostomy and internal stent placement. Patients in Group 4 not underwent surgery with urine diversion. It was found that the long-term etiopathogenetic therapy against the background of retention changes resulted in progression of changes and loss of renal function in 63% of cases. Early urine diversion, depending on its method allows preserving the functional ability of the kidneys in 70.8 to 94.4% of cases. The combination of early renal drainage with antituberculous polychemotherapy is significantly superior to conservative treatment, leads to a rapid reduction of chronic renal failure (CRF) and allows to subsequently perform the greatest number of reconstructive operations: in 62.6% of cases after the external drainage and in 73.3%--after internal drainage (p < 0.05). At the same time, good results of plastics were achieved only in patients undergoing a two-stage surgical treatment, and poor results (relapse of stricture, progression of hydroureteronephrosis or CRF) were significantly more often observed (60%) in patients without urine diversion (p < 0.05).