Reconstructive surgery for treatment of urogenital tuberculosis: 30 years of observation.

Tuberculosis has continued to be a public health problem around the world. The urogenital tuberculosis clinic in the Russian Scientific Research Institute of Phthisiopulmonology was founded in 1950. The development of reconstruction operations for those with urogenital tuberculosis began in 1960. Since then 4298 patients with urogenital tuberculosis have been treated, and 2364 operations have been performed: 885 to remove an organ, 531 to preserve an organ, and 948 for reconstruction. The cases of extrapulmonary tuberculosis in recent years have increased to 6.0%. Surgery for urogenital tuberculosis is performed after specific medical therapy has been tried, but it is difficult, particularly if it is a reconstruction. The clinical features and results of various ureteral neoimplantation procedures using intestinal transplants (ileocystoplasty, sigmoidocystoplasty, cecocystoplasty) are discussed.

[Direct endolymphatic administration of antitubercular drugs in patients with inflammatory diseases of the urogenital organs]. / Priamoe éndolimfaticheskoe vvedenie antibakterial'nykh preparatov bol'nym s vospalitel'nymi zabolevaniiami mochepolovykh organov.

Direct endolymphatic administration of broad-spectrum antibiotics was used in treatment of approximately 21 patients with complicated urogenital tuberculosis. The duration of the endolymphatic therapy ranged from 3 to 13 days. In the patients treated with endolymphatic administration of the antibiotics the effects were favourable. The use of the procedure were shown expedient because marked lesions in the urinary tracts, frequent chronic renal failure and the microbial flora resistance to the drugs lowered the efficacy of the treatment with the routine administration of the drugs. The drugs used i.e. klaforan and gentamicin were approved by the USSR Pharmacological Committee. The drugs were administered with dosator NDL-3 in original modification which provided continuous polycollector endolymphatic antibiotic therapy with simultaneous lavage of the lymphatic channel. It was shown expedient to use endolymphatic administration of antibiotics in treatment of complicated urogenital tuberculosis alone or in combination with the preoperative procedures.

[The tuberculin-transamidinase test--a new method for the diagnosis of renal tuberculosis]. / Tuberkulino-transamidinaznaia proba--novyi metod diagnostiki tuberkuleza pochek.

The possible use of the provocative standard test with subcutaneous administration of tuberculin combined with determination of the activity of transamidinase, a renal specific enzyme, in the serum and urine before and 24, 48, 72 and 96 hours after administration of tuberculin was studied for the first time in 63 patients with a purpose of diagnosing nephrophthisis. It was shown that a 2-fold or higher increase in the transaminidase activity in response to subcutaneous administration of 50 TU during the period from 24 to 72 hours could serve as a sign of nephrophthisis.