ROLE OF SUPRAVESICULAR URINE DIVERSION IN THE TREATMENT OF PATIENTS WITH RENAL AND URETHRAL TUBERCULOSIS

The article presents the results of the survey, etiopathogenetic and surgery treatment of 73 patients with nephrotuberculosis complicated by tuberculous ureteritis. Patients were divided into 4 groups. 1 - 3 Groups of patients underwent urine diversion by percutaneous puncture nephrostomy, open nephrostomy and internal stent placement. Patients in Group 4 not underwent surgery with urine diversion. It was found that the long-term etiopathogenetic therapy against the background of retention changes resulted in progression of changes and loss of renal function in 63% of cases. Early urine diversion, depending on its method allows preserving the functional ability of the kidneys in 70.8 to 94.4% of cases. The combination of early renal drainage with antituberculous polychemotherapy is significantly superior to conservative treatment, leads to a rapid reduction of chronic renal failure (CRF) and allows to subsequently perform the greatest number of reconstructive operations: in 62.6% of cases after the external drainage and in 73.3% - after internal drainage (p<0.05). At the same time, good results of plastics were achieved only in patients undergoing a two -stage surgical treatment, and poor results (relapse of stricture, progression of hydroureteronephrosis or CRF) were significantly more often observed (60%) in patients without urine diversion (p<0.05).

renal and urethral tuberculosis, early kidney drainage, reconstructive-plastic surgery