尿路結核知見補遺 第1報: 臨床統計的観察

Abstract

Clinical analysis was made on patients with urinary tuberculosis who visited the urological clinic, Tohoku University Hospital, during the 5 year period from April, 1959 to March, 1964, especially on 242 in-patients among them. 1) Incidence. Number of both out- and in-pati e nts with urinary tract tuberculosis tended to decrease during the period and a ratio of patients to all in-patients also decreased from 21 % , 1959 to 9 %, 1963. 2) Age and se x . The forth decade showed the highest frequency of the patient which were 86 cases (36 %). Fifty-nine cases (24 %) were in the third decade, 55 cases (23 %) in the fifth decade and 9 cases in the age of more than 60. The peak of age distribution seems to be turned toward the middle or old age groups. Regarding the sex, 139 cases (57 %) were male and 103 cases (43 %) were female. 3) Initial symptom and chief com p laint. Both the initial symptom and the chief complaint were mostly those of the vesical affection : pollakiuria was the most frequent and found in 113 cases (47 %) as initial symptom and in 75 cases (31 %) as chief complaint. 4) Affected side. The affected side of the disease was in right in 81 ca s es (33 %), in left in 88 cases (36 %) and in both in 73 cases (30 %). 5) Tuberculous past history. Tuberculous di s e ases were found in the history of 144 cases (60 %) ; tuberculous pleurisy in 53 cases (22 %), pulmonary tuberculosis in 35 cases (14 %), tuberculosis of the sexual organs in 32 cases (13 %) and tuberculous osteoarthritis in 24 cases (10 %). 6) Tuberculo u s complications. Tuberculosis of the sexual organs was the most frequent tuberculous complication and found in 75 cases (54 % of male patients), and was followed by pulmonary tuberculosis and tuberculous osteoarthritis in frequency. 7) Urinary findings. Urine was clear in 37 cases (15 % ) but albumin reaction was positive in 191 cases (70 %). Tuberculous bacilli was found either by culture or by staining in 120 cases (50 %). However, many of 79 patients without chemotherapy had some urinary findings ; clear urine in 6 cases (8 %), positive albumine in 71 cases (90 %) and positive tuberculous bacilli either by culture or by staining in 58 cases (73 %). 8) Pyelogram. According to Lattimer's classification, 116 cases (48 %) b e longed to group IV, 56 cases (23 %) to group II and 44 cases (18 %) to group III. Group IV was the largest in number of cases. 9) Therape u tic procedures. On 72 cases chemotherapy alone was performed and on 170 cases surgical procedures were performed in addition to chemotherapy. Of surgical procedures total nephrectomy was chosen most often which was done on 109 cases. Further, segmental nephrectomy and speleotomy were performed on 17 and 9 cases respectively. A variation of Tasker's operation and Sheele's operation were also performed as a vesicoplastic procedure on 10 cases and on 5 cases, respectively. 10) Duration of chemotherapy. The du r ation of the chemotherapy given was mostly 2 to 3 years. It was done on 27 of 100 cases for such years and on 23 cases for 1 to 2 years.