Destructive forms of renal tuberculosis.

The incidence of renal tuberculosis has declined slowly in recent years, but its development has also changed. There are silent forms with few symptoms of spread and without very great bladder pain; nevertheless these forms can be very destructive, and even on first presentation may show a destroyed kidney. Our Urological Clinic in Belgrade treated 1,890 patients during a period of 23 years. We cannot incriminate streptomycin or PAS as the only causes of a tendency to fibrosis or for the silent forms of ureteric stenosis. Yet it seems certain that the pathogenesis of the tubercle bacillus changed in different persons under treatment with streptomycin and other antibiotics. The following represents the renal tuberculosis cases we have seen in the Urological Clinic in Belgrade during 1950--1972.