泌尿、男生殖系結(jié)核-全文預(yù)覽
【正文】 It is only at this stage that symptoms ( of cystitis) are manifested. Pathogenesis A. kidney and ureter: ? As the disease progress, a caseous breakdown of tissue occurs until the entire kidney is replaced by cheesy material. ? Calcium may be laid down in the reparative process. ? The ureter undergoes fibrosis and tends to be shortened and straightened. This change leads to a “golfhole” (gaping) ureteral orifice, typical of an inpetent valve. Tuberculosis of kidney and ureter Tuberculosis of kidney and ureter Tuberculosis of kidney Pathogenesis B. bladder: ? Vesical irritability develops as an early clinical manifestation of the disease as the bladder is bathed by infected material. ? Tubercles form later, usually in the region of the involved ureteral orifice, and ulcerate—bleeding. ? Bladder bees fibrosed and contracted, this leads to marked frequency. ? Ureteral reflux or stenosis and hydronephrosis. Pathogenesis C. Prostate and seminal vesicles: ? The passage of infected urine through the prostatic urethra leads to invasion of the prostate and one or both seminal vesicles. ? There is no local pain. ? The primary hematogenous lesion in the genitourinary trace is in the prostate. ? Prostatic infection can ascend to the bladder and descent to the epididymis. Pathogenesis D. Epididymis and testis: ? Tuberculosis of the prostate can extend the epididymis. ? This is a slow process, there is usually no pain. ? If the epididymal infection is extensive and an abscess forms, it may rupture through the scrotal skin, thus establishing a permanent sinus, or it may extend into the testicle. Pathology ? 病理型腎結(jié)核 : ? 結(jié)核早期病變 , 結(jié)核菌通過(guò)血行傳播至腎皮質(zhì) —結(jié) 核結(jié)節(jié)和結(jié)核肉芽腫形成。 Pathology ? 臨床型腎結(jié)核 : ? 因細(xì)菌數(shù)量大，毒性高而機(jī)體抵抗力弱，結(jié)核結(jié)節(jié)融合、擴(kuò)大，逐漸向隋質(zhì)發(fā)展并在腎乳頭處破潰，患者出現(xiàn)臨床癥狀 。結(jié)核結(jié)節(jié)相互融合，形成干洛樣壞死、液化，形成膿腫。 Pathology ? 輸尿管結(jié)核 : ? 輸尿管結(jié)核最常見(jiàn)于下段，其次上段。 ? 膀胱結(jié)核潰瘍向外穿透 —可 形成膀胱陰道瘺或膀胱直腸瘺。 2. 部分腎切除： 局限在一極的病變 。 Prognosis ? In a high percentage of cases, ? Cure is obtained by medical means. ? Unilateral renal lesions have the best prognosis. Male genital tuberculosis ? 主要來(lái)源于其他部位的結(jié)核病灶，經(jīng)血行感染而來(lái)。 ? 輸精管增粗，呈串珠伏。 3. 若睪丸有病變 ， 病變靠近附睪 ， 則可連同附睪將睪丸部分切除 。 Conclusions ? Tuberculosis is the
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