Clinical manifestations of urinary tract tuberculosis

Urinary tract tuberculosis is mostly secondary to pulmonary tuberculosis. Tuberculosis lesions mainly attack kidney function and cause renal tuberculosis (Tubercurosis of kidney), but the typical clinical manifestations usually appear only when it spreads to the bladder: frequent urination, urgency, inability to hold urine, hematuria or purulent urine, which may be accompanied by low fever, weight loss, fatigue and anemia. Pathologically, urinary tract tuberculosis is part of systemic tuberculosis, most of which are secondary to pulmonary tuberculosis, and very few are secondary to intestinal tuberculosis or osteoarthritis tuberculosis. It can invade the kidney, urethra, bladder, urethral orifice, male prostate, seminal vesicles, male testicles, ejaculatory ducts, bilateral fallopian tubes and other locations.

The pathology of radiologically confirmed urinary male reproductive tuberculosis is basically as follows: When tuberculosis spreads to the urogenital system through menstruation or lymph nodes, it often invades the renal cortex first. Under the standard of suitable growth and development, it produces cheese necrosis, and then develops to the renal medulla, and develops into cheese necrosis in the renal papilla, and then spreads to the renal cupules to produce tuberculous fissures, that is, the typical symptoms of renal tuberculosis appear. Tuberculosis changes can flow to various parts of the urinary system along the urethra.

Clinical symptoms

Typical symptoms are frequent and urgent urination, inability to hold urine, hematuria or purulent urine. Systemic symptoms may include weight loss, low fever, fatigue or anemia. There may also be no symptoms and it is only discovered during a urine test.

X-rays

(1) The key symptom is the thickening of the renal parenchyma. The relative density of the calcification points is relatively low and not very clear. This is because there is a small amount of calcium accumulation in the cheese necrosis. The calcification points can be small and round, or they can be dispersed and multiple. When the whole kidney is calcified, the kidney can shrink and the renal function is very poor or non-existent. This type of diffuse thickening of the whole kidney is called "autonephrosis" and is more common in late-stage renal tuberculosis.

(2) Thickening of the urethra: Scattered calcium deposits are present along the urethra of patients with tuberculosis.

(3) Bladder thickening: There is often a high-density shadow on the inner wall of the bladder.

(4) The male prostate, seminal vesicles, and ejaculatory ducts also have scattered or curved high-density linear dot-like shadows.