Korean Journal of Nephrology 1989;8(2):263-270.

신결핵의 임상적 고찰 - 지난 30년간 1054예를 중심으로 -

이정주 , 윤종병

Abstract

To survey a clinico-pathological trends of genitour- inary tuberculosis of past 30 years, we observed 1054 patients with genitourinary tuberculosis who were managed at the Department of Urology, Pusan National University Hospital from 1958 to 1987 (the early period: 1958-1967, the middle period: 1968-1977 and the late period: 1978-1987) and the results were as follows. 1) The distribution of patients in each period was 342 cases in the early period, 361 in the middle period and 351 in the late period in which a natural decline in the number of patients between each period was not seen. However, the incidence of genitourinary tuberculosis treated at out patient department in each period was shown to be declining with 4.2% of the early period, 2. 8% of the middle period, and 1.6% of the late period. Also, the distribution in the patient age group was mainly of the third and fourth decades in the early and middle period, whereas, in the late period relatively nearly even distribution among the third, fourth and fifth decades of life was noted. 2) Initial complaints were irritable bladder symp- toms, renal and systemic symptoms in the order of frequency. Incidence of turbid urine was markedly de- creased but silent hematuria was slightly increased in the late period. 3) The detection rates of Acid-Fast Bacilli (AFB) by stained smear in untreated group were 26.5% in the early period, 54.4% in the middle period, and 58.1%(, in the late period. 4) On cystoscopy, progressive increase in the inci- dence of nonspecific inflammatory lesions were noted in the middle and late period compared to the early period that were 37.6%, 45.9% and 21.2%, respectively. 5) Uroradiologically, advanced excretory urographic findings including nonvisualized kidney were decreased insidiously. 6) Renal pelvis urine was dominant for the detection of AFB and proteinuria than the bladder urine and also showed lower specific gravity. 7) The interrelationship between the histopath- ological features of surgically resected kidney and the length of systemic chemotherapy showed that most tuberculomas were disappeared after 12 months of INH, PAS and SM (KM) regimen, and also disappeared after 6 months of INH, RIF and EMB (PZA) regimen.