高度な結核性尿管狭窄に対する外科的療法

Abstract

As one of the findings of urinary tuberculosis, ureteral strictures are observed frequently. It is difficult to decide what the most adequate method of treatment is and when the optimum timing of surgical operation. We have performed ureterocystoneostomy (nipple method) in three cases of marked tuberculous strictures of the lower ureter. These cases were otherwise indicated for nephrectomy. Prior to the operation, case 1 was treated with chemotherapy for 6 months; case 2 was treated for 14 months; case 3 was not treated because diagnosis as tuberculosis was not made. As these patients had renal tuberculosis and multiple strictures of the ureter, we have paid attention particularly on the post-operative progress. Renal function has been preserved for 1.5 to 55 years period after the operation. We can confirm that ureterocystoneostomy is also applicable safely for marked tuberculous strictures of the lower ureter.