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Issack FH, Bogale NT, Hassen SM, Ibrahim AI, Abdi AM, Bore TM, Answar IO. Unilateral Testicular Infarction a Very Rare Complication of Genital Tuberculosis: A Case Report and Literature Review. Res Rep Urol 2023; 15:479-484. [PMID: 37920685 PMCID: PMC10619968 DOI: 10.2147/rru.s434046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 10/28/2023] [Indexed: 11/04/2023] Open
Abstract
Background Genitourinary tuberculosis is the second most common form of extrapulmonary tuberculosis in developing countries. Isolated genital TB is rare, but testicular infarction is an unusual complication of delayed management, in which surgical intervention is warranted. Case Presentation A 29-year-old male non-smoker presents with painful left scrotal pain of 21 days. Initially managed with intravenous antibiotics, the disease progressed and resulted in testicular infarction. Left orchiectomy was performed, and the specimen was sent for histopathological examination, which revealed features consistent with a testicular tuberculous abscess. Conclusion Tuberculous epididymo-orchitis (TBEO) with testicular infarction was unusual. It is prudent to consider this in patients presenting with long-standing urinary symptoms, particularly in those unresponsive to the initial antibiotic therapy. It requires a high index of suspicion, especially in TB endemic areas.
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Affiliation(s)
- Feysel Hassen Issack
- Urology Unit, Department of Surgery, Jigjiga University Sheik Hassen Yabare Comprehensive Specialized Hospital, Jigjiga, Ethiopia
| | - Nahom Tadesse Bogale
- Urology Unit, Department of Surgery, Jigjiga University Sheik Hassen Yabare Comprehensive Specialized Hospital, Jigjiga, Ethiopia
| | - Samater Mohammed Hassen
- Urology Unit, Department of Surgery, Jigjiga University Sheik Hassen Yabare Comprehensive Specialized Hospital, Jigjiga, Ethiopia
| | - Abdulhafiz Idris Ibrahim
- Department of Radiology, Jigjiga University Sheik Hassen Yabare Comprehensive Specialized Hospital, Jigjiga, Ethiopia
| | - Abdurehman Mohamed Abdi
- Urology Unit, Department of Surgery, Jigjiga University Sheik Hassen Yabare Comprehensive Specialized Hospital, Jigjiga, Ethiopia
| | - Tariku Mulatu Bore
- Department of Pathology, Jigjiga University Sheik Hassen Yabare Comprehensive Specialized Hospital, Jigjiga, Ethiopia
| | - Isak Omer Answar
- Department of Pathology, University of Gondar, College of Medicine and Health Sciences, Gondar, Ethiopia
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Ambrosini F, Riccardi N, Occhineri S, Matucci T, Paraboschi I, Calarco A, Berrettini A, Tiseo G, Canetti D, Van Der Merwe A, Terrone C, Mantica G. Uncommon Haemorrhagic Cystitis of Infectious Origin: A Narrative Review for Urologists. Res Rep Urol 2023; 15:365-373. [PMID: 37564174 PMCID: PMC10411501 DOI: 10.2147/rru.s412278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 07/20/2023] [Indexed: 08/12/2023] Open
Abstract
Purpose Haemorrhagic cystitis may be due to different etiologies with infectious diseases representing an insidious cause to diagnose. The aim of this narrative review is to provide a comprehensive overview of less common but difficult-to-diagnose causes of infectious haemorrhagic cystitis of bacterial, mycobacterial, and parasitic origin, Moreover, we highlight possible diagnostic tools and currently available treatment options in order to give an updated tool for urologists to use in daily practice. Patients and Methods The search engine PubMed was used to select peer-reviewed articles published from 1/Jan/2010 to 31/Aug/2022. Results Bacteria, fungal, TB and schistosomiasis are uncommon causes of haemorrhagic cystitis burdened by high morbidity, especially if not promptly diagnosed. Conclusion Because haemorrhagic cystitis ranges in severity from mild dysuria associated with pelvic discomfort to severe life-threatening haemorrhage, punctual diagnosis, and immediate treatment are essential to avoid further complications.
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Affiliation(s)
- Francesca Ambrosini
- IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy
| | - Niccolò Riccardi
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- StopTB Italia Onlus, Milan, Italy
| | - Sara Occhineri
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- StopTB Italia Onlus, Milan, Italy
| | - Tommaso Matucci
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- StopTB Italia Onlus, Milan, Italy
| | - Irene Paraboschi
- Department of Pediatric Urology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Alfredo Berrettini
- Department of Pediatric Urology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giusy Tiseo
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Diana Canetti
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - André Van Der Merwe
- Department of Urology, Faculty of Medicine and Health Sciences, 26697 Stellenbosch University, Cape Town, South Africa
| | - Carlo Terrone
- IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy
| | - Guglielmo Mantica
- IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy
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Prihadi JC, Putra AC, Wahyudi Y. Biopsy-confirmed Genitourinary Tuberculosis in a Secondary Health Care Hospital: An Evidence-based Clinical Review. Res Rep Urol 2021; 13:133-137. [PMID: 33763390 PMCID: PMC7982704 DOI: 10.2147/rru.s286899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 02/08/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction Tuberculosis (TB) is a worldwide disease and remains a major public health problem in developing countries, with 95% of cases occurring in developing countries, including Indonesia. It is caused by Mycobacterium tuberculosis, an acid-fast aerobic bacillus. When M. tuberculosis infects other than lung, it is called extrapulmonary tuberculosis (EPTB). Among other organs, genitourinary tuberculosis (GUTB) is responsible for 30–40% of all EPTB cases. Methods The study was conducted in a secondary health-care hospital in central Jakarta over a five-year period. We took data from hospital’s medical records and collected all the positive histopathological reports on biopsied tissue of the genitourinary tract from 2014–2019. Results Eleven patients showed positive histopathological results for TB on their biopsied genitourinary tissue. The genitourinary tracts involved were as follows: prostate (n=2), kidney (n=1), ureter (n=2), epididymis (n=1), epididymo-orchitis (n=1), bladder (n=4). All of them presented with specific genitourinary symptoms, such as lower urinary tract symptoms (LUTS) (n=8), dysuria (n=9), urinary retention (n=2), flank pain (n=6), and incontinence (n=1). Nine of 11 patients (81.8%) exhibited systemic manifestations, with fever being the most common (n=8), followed by malaise (n=6), dyspepsia syndrome (n= 4), and weight loss (n=3). Discussion Consistent with other studies, our research found that the prevalence of GUTB is substantially decreased with advancing age. Kidney is the most common site infected in GUTB infection. GUTB is easily overlooked, because its signs and symptoms are usually typical of a conventional bacterial cystitis. Conclusion Because of its insidious nature and late-onset symptoms, diagnosis of GUTB is often late to approach, leading to higher morbidity and even mortality rate. This leads into further complications of the disease, which are largely preventable by a correct and timely diagnosis followed by appropriate therapy.
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Affiliation(s)
- Johannes Cansius Prihadi
- Department of Surgery, Urology Division, School of Medicine and Health Sciences, Atma Jaya Catholic University, Jakarta, Indonesia.,Department of Urology, St. Carolus Hospital, Jakarta, Indonesia
| | - Andika Chandra Putra
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.,Department of Pulmonology and Respiratory Medicine, St. Carolus Hospital, Jakarta, Indonesia
| | - Yuvi Wahyudi
- Department of Urology, St. Carolus Hospital, Jakarta, Indonesia
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Radwan A, Menias CO, El-Diasty MT, Etchison AR, Elshikh M, Consul N, Nassar S, Elsayes KM. Multimodality Imaging of Genitourinary Tuberculosis. Curr Probl Diagn Radiol 2020; 50:867-883. [PMID: 33272721 DOI: 10.1067/j.cpradiol.2020.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 10/10/2020] [Accepted: 10/16/2020] [Indexed: 01/27/2023]
Abstract
Tuberculosis (TB) prevalence has increased over the past few decades, especially in the developing world. The genitourinary tract is the most common extra-pulmonary location of TB. Symptoms of genitourinary TB are often vague. Diagnosis of genitourinary TB requires a high level of clinical suspicion. Healthcare providers must be familiar with genitourinary TB imaging features on different imaging modalities and how to correlate these findings with urine studies and histologic analysis to definitively diagnose genitourinary TB.
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Affiliation(s)
- Ahmed Radwan
- University of Texas MD Anderson Cancer Center, Houston, TX.
| | | | - Mohamed T El-Diasty
- Radiology department, King AbdulAziz University Hospital, Jeddah, Saudi Arabia
| | | | | | | | - Sameh Nassar
- University of Texas MD Anderson Cancer Center, Houston, TX
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Complicated Urinary Tract Tuberculosis in a 13-Year-Old Adolescent with Chronic Kidney Disease and Antituberculous Drug-Induced Hepatotoxicity. Case Rep Infect Dis 2019; 2019:7370150. [PMID: 31781434 PMCID: PMC6855035 DOI: 10.1155/2019/7370150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 08/29/2019] [Indexed: 11/17/2022] Open
Abstract
Urinary tract tuberculosis (TB) is a rare extrapulmonary manifestation of TB in children. The disease is potentially underdiagnosed because it clinically resembles other urinary tract infections. A 13-year-old adolescent girl presented with pain, difficulty in micturition, and gross hematuria for almost two years before admission, and she had left flank pain since one year ago and significant loss of body weight during the illness. The close TB contact was her grandmother who was on TB treatment. Acid-fast bacilli yielded positive result, Mantoux test was positive (17 mm), urine GeneXpert MTB/Rif was positive; tuberculoma was identified on kidney histopathology, and a diuretic renogram revealed an uncorrected glomerular filtration rate (GFR) of the right and left kidney to be 32.5 mL/min/1.73 m2 and 5 mL/min/1.73 m2, respectively. During the treatment, oral anti-TB drug-induced hepatotoxicity (ADIH) occurred to the patient. This problem was solved with management according to the British Thoracic Society (BTS) guidelines. Screening TB in children is very important for a better outcome. If children complain of some complicated urinary tract infection, TB should be suspected. Optimaly treating children with urinary tract TB exagerrated with ADIH and CKD is very challenging.
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Koul AN, Kassana BA, Rather AR. Utility of GeneXpert in the diagnosis, reliance on urine microscopy and clinical characteristics of genitourinary tuberculosis at a tertiary care hospital. Indian J Med Microbiol 2018; 36:93-96. [PMID: 29735834 DOI: 10.4103/ijmm.ijmm_18_114] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background One-third of the world's population is infected with tuberculosis (TB) with new infection occurring every second. In humans, TB is primarily caused by Mycobacterium tuberculosis(MTB). Genitourinary TB (GUTB) is still a major health problem in many developing countries including India and had been declared by the World Health Organisation as 'public health emergency' in 1993. Materials and Methods This is a prospective study conducted at a tertiary care hospital involving 46 patients who presented with clinical feature suggestive of GUTB - urine specimens of these 46 patients were analysed for acid-fast bacilli (AFB), AFB culture, GeneXpert, and other relevant investigations were done to reach the diagnosis. Majority of patients were female (65.25%). This is especially relevant to rural and low socioeconomic areas in developing countries where women's health is worse than men's (in terms of nutrition); women's risk of disease may be increased. Most of our patients were above 30 years of age and exhibited nonspecific symptoms such as dysuria, haematuria and frequency. All patients were put on antitubercular drugs and followed as per the guidelines. Conclusion The sample size in the present study is small to arrive at a brisk inference, but it may safely be postulated that yield of detection for GeneXpert may be improved using multiple sampling, especially the early morning ones. It is also pertinent to mention here that GeneXpert may not be able to pick up mutant genomes.
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Affiliation(s)
- Ajaz Nabi Koul
- Department of Medicine and Infectious Diseases, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Basharat A Kassana
- Department of Medicine and Infectious Diseases, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Aadil Rafeeq Rather
- Department of Medicine and Infectious Diseases, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
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Abstract
Urogenital tuberculosis is the second most frequent form of extrapulmonary tuberculosis. Starting with a pulmonary focus, 2 to 20% of patients develop urogenital tuberculosis through hematogenous spread to the kidneys, prostate, and epididymis; through the descending collecting system to the ureters, bladder, and urethra; and through the ejaculatory ducts to the genital organs. Urogenital tuberculosis occurs at all age ranges, but it is predominant in males in their fourth and fifth decades. It is a serious, insidious disease, generally developing symptoms only at a late stage, which leads to a diagnostic delay with consequent urogenital organ destruction; there are reports of patients with renal failure as their initial clinical presentation. Although the condition has been long recognized by nephrologists, urologists, and infectious disease specialists, urogenital tuberculosis is still largely unknown. Even when suggestive findings such as hematuria, sterile pyuria, and recurrent urinary infections are present, we rarely remember this diagnostic possibility. Greater knowledge of the features of urogenital tuberculosis then becomes relevant and should emphasize the importance of an early diagnosis.
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Yadav S, Singh P, Hemal A, Kumar R. Genital tuberculosis: current status of diagnosis and management. Transl Androl Urol 2017; 6:222-233. [PMID: 28540230 PMCID: PMC5422679 DOI: 10.21037/tau.2016.12.04] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Genitourinary Tuberculosis (GUTB) is the second most common extra-pulmonary manifestation of tuberculosis (Tb) and an isolated involvement of genital organs is reported in 5–30% of the cases. Genital involvement results from primary reactivation of latent bacilli either in the epididymis or the prostate or by secondary spread from the already infected urinary organs. The epididymis are the commonest involved organs affected primarily by a hematogenous mode of spread. Tb is characterized by extensive destruction and fibrosis, thus an early diagnosis may prevent function and organ loss. The gold standard for diagnosis is the isolation and culture of mycobacterium tuberculosis bacilli and in the cases of suspected GUTB, it is commonly looked for in the urinary samples. All body fluid specimens from possible sites of infection and aspirates from nodules must also be subjected to examination. Radiologic investigations including ultrasonography and contrast imaging may provide supportive evidence. Anti-tubercular chemotherapy is the first line of management for all forms of genital Tb and a 6 months course is the standard of care. Most patients with tubercular epididymo-orchitis respond to antitubercular therapy but may require open or percutaneous drainage. Infertility resulting from the tubercular affliction of the genitalia is multifactorial in origin and may persist even after successful chemotherapy. Multiple organ involvement with obstruction at several sites is characteristic and most of these cases are not amenable to surgical reconstruction. Thus, assisted reproduction is usually required. Post treatment, regular annual follow up is recommended even though, with the current multi drug therapy, the chances of relapse are low.
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Affiliation(s)
- Siddharth Yadav
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India
| | - Prabhjot Singh
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India
| | - Ashok Hemal
- Baptist Medical Centre, Wake Forest University, Winston-Salem, NC, USA
| | - Rajeev Kumar
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India
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Dangi AD, Kodiatte TA, Kumar S, Kekre NS. A rare cause of anuria: Bilateral synchronous isolated mid-ureteric tubercular lesions. Indian J Urol 2015; 31:360-2. [PMID: 26604451 PMCID: PMC4626924 DOI: 10.4103/0970-1591.155801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A young female presenting with right flank pain, fever, raised creatinine and bilateral hydronephrosis was treated with antibiotics elsewhere, with presumptive diagnosis of bilateral pyelonephritis. She had partial relief in symptoms and her creatinine level showed an improvement. Three months later during evaluation at our center she had anuria, hypertensive crisis and pulmonary edema which were managed with emergency bilateral percutaneous nephrostomies. Cross-sectional imaging and ureteroscopy suggested bilateral synchronous intramural mid-ureteric lesions as underlying pathology. Histopathology of the ureteric segments during laparotomy revealed caseating granulomas suggestive of tuberculosis. This clinical presentation has not been previously described in urinary tuberculosis.
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Affiliation(s)
- Anuj D Dangi
- Department of Urology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Thomas Alex Kodiatte
- Department of Pathology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Santosh Kumar
- Department of Urology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Nitin S Kekre
- Department of Urology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
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Khan S, Haroon N, Azami R, Bawa T. Isolated tuberculosis of tunica albuginea and tunica vaginalis presenting as acute hydrocoele: a diagnostic dilemma. BMJ Case Rep 2015; 2015:bcr-2014-207744. [PMID: 26347242 DOI: 10.1136/bcr-2014-207744] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
We report the first case of genital tuberculosis (TB) occurring in tunica albuginea (TA) and tunica vaginalis (TV) presenting as acute hydrocoele. A 35-year-old man presented with acute onset left scrotal swelling. Physical examination revealed left hemiscrotal swelling with overlying skin erythema and tenderness. Surgical exploration was carried out due to increasing pain and per operatively found thickened TA and TV with a single small nodule on TA. Histopathology revealed typical granuloma formation, however, no Mycobacterium was seen. Subsequent Ziehl-Neelsen stain on separate tissue specimen confirmed the presence of acid-fast bacilli. Based on these findings, antituberculous treatment was started involving daily isoniazid (INH), rifampicin, ethambutol and pyrazinamide for 2 months and further INH and rifampicin for further 4 months.
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Affiliation(s)
- Salma Khan
- Memon Medical Institute, Karachi, Pakistan
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Ebadi M, Kajbafzadeh AM, Tourchi A, Mousavian AA. Endoureterotomy as the initial management of concurrent ureteropelvic and ureterovesical junction obstruction after failed conservative therapy. Urology 2013; 82:214-9. [PMID: 23601441 DOI: 10.1016/j.urology.2013.02.048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 02/20/2013] [Accepted: 02/26/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To present the results of our experience with endoureterotomy as the initial management of ureterovesical junction obstruction (UVJO) with coexisting primary or secondary obstruction at the ureteropelvic junction (UPJO) level. METHODS A total of 490 children with 561 ureterorenal units were referred to our center for further management of UVJO. Of these, 47 ureterorenal units had concomitant UPJO. All patients underwent endoureterotomy. Patients were monitored by performing clinical examinations, urine culture, ultrasonography, and radionuclide renal scan. RESULTS Mean procedure time for endoureterotomy was 20 minutes (range, 14-33 minutes). No postoperative complications were observed. With a mean follow-up of 27 months, 39 of the 47 ureters with concomitancy (82.97%) showed resolution of both pathologies after the initial endoureterotomy, and 4 patients experienced resolution after redo endoureterotomy, with an overall success rate of 91.48%. Three ureterorenal units (6.38%) underwent further ureteral reimplantation. Pyeloplasty was performed on 3 ureterorenal units (6.38%), which led to complete resolution in all. CONCLUSION Performing initial endoureterotomy for the management of UVJO concomitant with UPJO provides promising results in spontaneous resolution of UPJO and complete resolution or decrease in hydronephrosis and can be proposed as an effective and safe temporizing alternative in selected patients.
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Affiliation(s)
- Maryam Ebadi
- Tehran University of Medical Sciences, Tehran, Iran
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Veerappan I, Shanmugam A, Kumar S, Velayutham P. Bilateral psoas and bilateral perinephric abscesses complicating acute pyelonephritis in pregnancy. Indian J Nephrol 2013; 23:59-62. [PMID: 23580809 PMCID: PMC3621243 DOI: 10.4103/0971-4065.107213] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Acute pyelonephritis complicates 1-2% of pregnancies and causes significant maternal and fetal morbidity and mortality. The diagnosis of renal tuberculosis (TB) is often delayed and commonly presents with sterile pyuria or along with other pyogenic organisms. We report a case where the diagnosis of renal TB was missed in a pregnant woman when she presented with acute pyelonephritis, septic shock, and acute renal failure. There was clinical recovery with antibiotics, but bilateral psoas and perinephric abscesses (TB, Enterococcus sp., and E. coli) were diagnosed when she presented with loin pain and palpable left renal angle swelling. Bilateral psoas abscess due to TB in the absence of skeletal TB and human immunodeficiency virus infection is rare. The presentation of renal TB in pregnancy, its complications, and its management are discussed.
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Affiliation(s)
- I. Veerappan
- Department of Nephrology, Pondicherry Institute of Medical Sciences, Pudhucherry, India
| | - A. Shanmugam
- Department of General Medicine, Mahatma Gandhi Medical College, and Research Institute, Pudhucherry, India
| | - S. Kumar
- Department of Microbiology, Mahatma Gandhi Medical College, and Research Institute, Pudhucherry, India
| | - P. Velayutham
- Department of Radio-diagnosis, Mahatma Gandhi Medical College, and Research Institute, Pudhucherry, India
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14
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Dysuria: don’t take it lightly. Arch Gynecol Obstet 2011; 283:657-8. [DOI: 10.1007/s00404-010-1461-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2010] [Accepted: 03/29/2010] [Indexed: 10/19/2022]
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Reuter S, Büssemaker E, Pabst D, Eltze E, Hillebrand U. An unconscious 76-year-old woman with renal failure and hyperechoic kidney lesions. NDT Plus 2009; 2:184-5. [PMID: 25949328 PMCID: PMC4421351 DOI: 10.1093/ndtplus/sfn207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | | | - Elke Eltze
- Department of Pathology University of Münster , Münster Germany
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