Association of Surgeons of East Africa and College of Surgeons of East Central and Southern Africa
Abstract
Background : Genito-urinary tuberculosis (GUTB) affects kidneys and
bladder more frequently leading to scarring and eventually loss of
function. Reconstructive surgical procedures are implemented to
preserve the function by relieving obstruction of the urinary tract.
The main objective of this study was to evaluate the outcome of urinary
reconstructive surgical procedures in terms of improvement in renal
function and quality of life. Methods :This was retrospective analysis
of all patients treated for tuberculous stricture of the ureter and
scarring of the bladder from January 2001 to December 2005. Outcome of
interventions were assessed using IVU, TC-DTPA renogram and serum
creatinine level. Results : Among the 160 genito-urinary tuberculosis
cases diagnosed in the 5 year period, only 51 patients fulfilled the
inclusion criteria and were managed with reconstructive surgery alone
or in combination with temporary diversion. Sixteen (31.5%) patients
had elevated serum creatinine level greater than 1.5mg% out of which
Nadir serum creatinine level less than 1.5mg% was found in only 9
patients following various procedures. Pan urethral or multiple segment
involvement occurred in 24 ureters of which 10 required eventual
definitive reconstructive surgery. Twenty eight bladders were found
scarred of which 17 needed augmentation procedures. Conclusion : Based
on acceptable renal function using Tc-scan, renogram and other
functional assessments an overall favourable outcome of 92% at median
follow up of 18 (6-48) months was observed