鳥取県,島根県の尿路結核 - 第1報

Abstract

Based on 5 years experience from 1965 to 1969 at 8 urological clinics in SAN-IN area, clinicostatistical observations on urinary tuberculosis were made. 1. The total outpatients were 21, 437. Cases with urinary tuberculosis were 1.81% (388) of outpatients and 3.86% of inpatients. Yearly decrease of incidence was not observed during 5 years. 2. The highest incidence was observed in the third decade followed by the fifth decade. Unexpectedly, 9.9% was noticed in patients over sixty of age. The incidence ratio of male to female was about 2 : 1. 3. The right kidney was affected in 41 cases (31. 3%), the left in 55 (42%) and the bilateral kidneys in 25 (19.1%). 4. Tuberculous diseases were found in the anamneses of 41 cases(38.0%) : pulmonary tuberculosis (34.1%), genital tuberculosis (31. 7%), pleuritis (24.4%) and tuberculosis in the bones and joints (14.6%). 5. Tuberculosis beside the urinary tract was described in 33 cases (25.2%): genital tuberculosis (66.6%) and pulmonary tuberculosis (18.2%). 6. Chief complaints were mostly bladder symptoms (178 cases; 45.9%). Others were cloudy urine (12.9%), hematuria (12.4%) and lumbar pain (5.9%). 7. The incidence of cloudy urine, albuminuria and pyuria showed no difference between patients with and without chemotherapy. The patients who received chemotherapy showed the lower incidence of hematuria and positive acid-fast bacilli on smear preparation. 8. Severity in cystoscopic findings correlated with that in pyelographic ones. 9. Chemotherapy alone was performed on 42 cases (29.8%) and surgical procedures on 99 cases (63.7%), 95% of which was combined with chemotherapy. Of surgical procedures, total nephrectomy was done on 84 cases (90.3%). Ureterocystoneostomy (7 cases), partial nephrectomy, nephrostomy, etc. were also performed.