泌尿、男生殖系結(jié)核-在線瀏覽
2025-07-13 12:13本頁面
【正文】 ent 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 findings: persistent pyuria ( “sterile” pyuria) cultures for tubercle bacilli from the first morning urine are positive in a very high percentage of cases of tuberculous infection. the blood count may be normal or anemia. Sedimentation rate is usually accelerated. the tuberculin test should be performed. Clinical findings B. Signs: 6. XRay findings: A chest film: evidence of tuberculosis A plain film of abdomen: enlargement of one kidney of obliteration of the renal shadows due to abscess. Renal stones are found in 10% of cases. Calcificatin of the ureter may be noted. Clinical findings B. Signs: 6. XRay findings: IVP—the typical changes include: a “motheaten” appearance of
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