15 To 20% of Tuberculosis patients have Genito Urinary TB as the prime focus. Tuberculosis is the most common opportunistic infection in AIDS patients.
DEVELOPMENT OF DISEASE:
Upto 50% of the active disease occurs within two years of infection.
The development of the disease depends on interactions between the pathogen and immune response of the patients. The organism evokes a humoral and cellular response and the latter response determines the outcome of the infections.
a) Renal TB is caused by the activation of a previous blood – borne metsetatic renal infection from the lungs.
The organisms settle near the blood vessels close to the glomeruli and a caseating granuloma develops consisting of langhans
The healing process results in fibrosis and the classical calcified lesion is seen. Fibrous tissue can cause a stricture in the
b) Tuberculosis of the ureter and bladder are always secondary to renal infections. The most common site is the uretero-vesical
c) Bladder lesionstart around the ureteric orifice with inflamed odematous mucosa with occasional TB ulcer. Fibrosis
d) TB of the prostrate, testis and epidydimis are spread by blood-borne infections. The globus minor of the epidydimis which is highly vascular is the most commonly affected site and from here the infection spreads to the testis. TB of the prostrate, urethra and penis are rare.
MEDICAL MANAGEMENT: PRIMARY DRUGS USED:
SURGICAL MANAGEMENT: The indications for nephrectomy are:
1. Non-functioning kidney with or without calcifications.
Partial neprectomy is indicated if there is a polar lesion.
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