泌尿、男生殖系結(jié)核(編輯修改稿)
2025-06-22 12:13 本頁面
【文章內(nèi)容簡介】 核 附睪結(jié)核 Clinical findings ? Tuberculosis of the genitourinary tract should be considered in the presence of any of the following situations: 1. Chronic systitis that refuses to respond to therapy. 2. The finding of without bacteria in culture of the urinary sediment. 3. Gross or micorscopic hematuria. 4. Enlarged epididymis with a beaded or thickened 5. A chronic draining scrotal sinus 6. Induration or nodulation of the prostate and thickening of one or both seminal vesicles. Clinical findings ? The diagnosis rests on the demonstration of tubercle bacilli in the urine by culture. ? The extent of the infection is determined by: 1. The palpable findings in the epididymises, prostate and seminal vesicles 2. The renal and ureteral lesions as revealed by IVP 3. involvement of the bladder as seen through the cystoscope 4. The degree of renal damage as measured by loss of function. 5. The presence of tubercle bacilli in one or both kidneys. Clinical findings A. Symptoms: ? There is no classic clinical picture of renal tuberculosis ? Most symptoms of this disease, are vesical in origin (cystitis) Clinical findings A. Symptoms: 1. Frequency: the earliest symptoms of renal tuberculosis may arise from secondary vesical involvement. 2. Pyuria: no bacteria is found in the culture of urine. 3. Hematuria: is occasionally found and is of either renal or vesical origin. 50~60%, gross hematuria: 10% 4. Pain and mass: dull ache in the flank. The passage of a blood clot, secondary calculi, or a mass of debris may cause renal and ureteral colic. 5. Some of the nonspecific plaints: vague generalized malaise, fatigability, lowgrade but persistent fever, and night sweats. Clinical findings B. Signs: 1. Evidence of extragenital tuberculosis may be found (lungs, bone, lymph nodes) 2. Kidney—usually no enlargement or tenderness of the involved kidney. 3. External genitalia: a thickened, nontender epididymis, a chronic draining sinus through the scrotal skin. 4. Prostate and seminal vesicles: tuberculous prostate shows areas of induration, even nodulation. The involved seminal vesicleis indurated, enlarged, and fixed. Clinical findings B. Signs: 5. Laboratory
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