Positive histological tuberculous findings despite stable sterility of the urine on culture: results of 111 nephrectomies and partial nephrectomies.

The therapy of genitourinary tuberculosis has changed: 'néphrectomie nécessaire' has been replaced by 'néphrectomie opportune'. Today, it is generally assumed that tuberculosis can be cured completely by chemotherapy. The following question must, however, be asked: How far may the stable sterility of the urine be considered as a complete cure? In order to assess the efficiency of chemotherapy as a function of time and dosage, the activity of tuberculosis of the kidneys was investigated on the basis of the histological preparation, after removal of the tuberculous renal tissue. Despite stable sterilization of the urine, 15% of the cases showed active tuberculosis. Using the triple therapy combination of rifampicin, ethambutol and isoniazid, the disease was found no longer to be active after 2--3 months of treatment in 90% of the cases. A longer period of treatment brought no further improvement.