尿路性器結核の最近の動向 - 3.奈良県立医科大学泌尿器科における尿路性器結核の臨床統計的観察

Abstract

A clinic-statistical observation were made on newly diagnosed inpatient with genitor-urinary tuberculosis in the urological clinic of Nara Medical University during the period from 1963 to 1971. Following results were obtained. 1) Incidence of outpatients and inpatients with genitor-urinary tuberculosis showed stagnation, however incidence of patients with genital tuberculosis slightly decreased during the period of 9 years. 2) Age distribution for the highest incidence was found in the fourth decade by inpatients with urinary tuberculosis, and in the third decade by inpatients with genital tuberculosis. 3) The male to female ratio was 1.1 with male predominance of the inpatients with urinary tuberculosis. 4) 17.6% of the inpatients with genitor-urinary tuberculosis, and 24.7% of the inpatients with urinary tuberculosis have family history of some tuberculous diseases. 36.6% of the inpatients with genitor-urinary tuberculosis, and 42.7% of the inpatients with urinary tuberculosis had some extra-genitourinary tuberculosis previously. 5) Tuberculous complications in the inpatients with urinary tuberculosis were as follows: tuberculous stricture of the ureter in 41.6%, bladder tuberculosis in 37.1%, tuberculous contracted bladder in 4.7%. Tuberculous complications of extra-urinary tuberculosis were pul-monary tuberculosis in 14.6%, spondylitis tuberculosa in 5.6%, complication with genital tuber-culosis in the male patients was found in 38.3%. On the other hand, tuberculous complications in the inpatients with genital tuberculosis were urinary tuberculosis in 29.5%, other tuberculous diseases in 13.1%. 639 6) The most frequent chief complaint was bladder symptom (47.2%) by patients with urinary tuberculosis, and swelling of scrotal contents by patients with genital tuberculosis (62.5%) . 7) Incidence of pyuria in patients with urinary tuberculosis was found in high frequency (82.0%). Mycobacterium tuberculosis in urine was positive in 34.8% by staining, and in 43.8% by culture. 8) The affected side of renal tuberculosis was left in 38.2% right in 38.2%, and both sides in 15.7%. Side of epididymitis tuberculosa was left in 33.9%, right in 42.9% and both sides in 23.2% However, there was no significant difference. 9) Classification of pyelogram according to Lattimer on 89 cases were as follow: IV 56 (62.9%), III 18 (20.2%), II 8 (9.0%), I 15 (5.6%), and 02 (2.2%). 10) 30 cases (33.7%) of 89 cases with renal tuberculosis were treated by chemotherapy only and 59 cases of them had some surgical procedure in addition to chemotherapy. Further, repeated dilatations of tuberculous ureteral stricture by trausurethral ureter-catheter retaining method were applied on two cases in addition to chemotherapy. Therefore, we are convinced that this method could be one of the conservative and preventive methods for the case of renal tuberculosis with tuberculous ureteral stricture.