Hidrocele como manifestación inicial de tuberculosis genitourinaria y miliar / Hydrocele as initial manifestation of genitourinary and miliary tuberculosis / Hidrocele como manifestação inicial da tuberculose geniturinária e miliar

Introducción. La tuberculosis es una enfermedad infectocontagiosa que puede afectar cualquier órgano del cuerpo, incluyendo el sistema genitourinario, representando el 33.7-45.5 % de las tuberculosis extrapulmonares. El objetivo de este trabajo es reportar el caso de un paciente con hidrocele como manifestación inicial de tuberculosis genitourinaria y miliar, enfermedad que no se sospechaba. Presentación del caso. Paciente masculino previamente sano, que consulta a urgencias por orquialgia e hidrocele bilateral, con secreción purulenta por escroto, requiriendo manejo antibiótico intravenoso e hidrocelectomía derecha, con hallazgos intraoperatorios de engrosamiento del epidídimo derecho, y drenaje de material caseoso y purulento. Se realizó epididimectomía ipsilateral, se solicitaron pruebas de detección de bacilos tuberculosos en espécimen y derivado proteico purificado, que fueron positivas. En el postoperatorio presentó sintomatología respiratoria; paraclínicos evidenciaron compromiso pulmonar, pleural y de la vía urinaria por bacilos tuberculosos. Se inicia manejo antituberculoso con evolución satisfactoria. Discusión. El genitourinario es considerado el segundo sistema con mayor afectación de tuberculosis extrapulmonar. El órgano más afectado es el riñón (en un 80 % con respecto a los demás) y el órgano genital es el epidídimo (22 - 55 %). Debe sospecharse en pacientes con síntomas urinarios crónicos sin causa aparente. Se asocia a una alta tasa de morbimortalidad por infertilidad y falla renal. Conclusiones. A pesar de su sintomatología inespecífica y de tratarse de una entidad poco sospechada, la tuberculosis genitourinaria debe descartarse al existir tuberculosis pulmonar. Su diagnóstico y tratamiento oportuno serán de gran importancia para evitar complicaciones secundarias. Cómo citar: Álvarez-Jaramillo J, Ortiz-Zableh AM, Tarazona-Jiménez P, Ortiz-Azuero A. Hidrocele como manifestación inicial de tuberculosis genitourinaria y miliar. MedUNAB. 2019;22(1):71-78. doi:10.29375/01237047.3534

Introduction. Tuberculosis is an infectious disease that can affect any organ in the body, including the genitourinary system, which accounts for 33.7 - 45.5 % of non-pulmonary tuberculosis cases. The purpose of this paper is to report a case of hydrocele as initial manifestation of genitourinary and miliary tuberculosis, which was an unsuspected disease. Case Presentation. Previously healthy male patient is admitted to emergencies due to orchialgia and bilateral hydrocele, with purulent secretion from the scrotum. Was managed with intravenous antibiotic and right hydrocelectomy. Intraoperative findings of thickening of right epididymis and drainage of caseous and purulent material. Ipsilateral epididymectomy was performed; testing for detection of tubercle bacillus in specimen and purified protein derivative was requested, and was found positive. In the postoperative period, respiratory symptoms arose; paraclinical tests found compromised lungs, pleura and urinary tract by tubercle bacillus. Antituberculous treatment was initiated with satisfactory evolution. Discussion. The genitourinary system is the second-most affected system by nonpulmonary tuberculosis. The most affected organ is the kidney (by 80 % compared to the others) and the most affected genital organ is the epididymis (22 - 55 %). It should be suspected in patients with chronic urinary symptoms with no apparent cause. It is associated with a high rate of morbidity and mortality due to infertility and kidney failure. Conclusions. Despite the non-specific symptoms and because it is not normally a suspected entity, genitourinary tuberculosis should be ruled out when pulmonary tuberculosis exists. Timely diagnosis and treatment are very important in order to prevent secondary complications. Cómo citar: Álvarez-Jaramillo J, Ortiz-Zableh AM, Tarazona-Jiménez P, Ortiz-Azuero A. Hidrocele como manifestación inicial de tuberculosis genitourinaria y miliar. MedUNAB. 2019;22(1):71-78. doi:10.29375/01237047.3534

Introdução. A tuberculose é uma doença infecciosa que pode afetar qualquer órgão do corpo, incluindo o sistema geniturinário, representando 33.7 a 45.5 % da tuberculose extrapulmonar. O objetivo deste trabalho é relatar o caso de um paciente com hidrocele como uma manifestação inicial de tuberculose geniturinária e miliar, uma doença que não se suspeitava. Apresentação do caso. Paciente do sexo masculino previamente saudável, que consultou a emergência para orquialgia e hidrocele bilateral, com secreção purulenta do escroto, necessitando de tratamento antibiótico endovenoso e hidrocelectomia direita, com achados intraoperatórios de espessamento do epidídimo direito e drenagem de material purulento e caseoso. Foi realizada uma epididimectomia ipsilateral e foram solicitados exames de bacilos tuberculosos em espécime e derivado proteico purificado, que foram positivos. No pós-operatório, apresentou sintomas respiratórios; testes para-clínicos mostraram comprometimento pulmonar, pleural e do trato urinário devido a bacilos da tuberculose. Começa-se o tratamento antituberculose com evolução satisfatória. Discussão. O sistema geniturinário é considerado o segundo com maior comprometimento da tuberculose extrapulmonar. O órgão mais afetado é o rim (80 % em relação aos demais) e o órgão genital é o epidídimo (22 a 55 %). Deve-se suspeitar em pacientes com sintomas urinários crônicos sem causa aparente. Está associada a uma alta taxa de morbimortalidade devido à infertilidade e insuficiência renal. Conclusões. Apesar de sua sintomatologia inespecífica e de ser uma entidade pouco suspeitada, a tuberculose geniturinária deve ser descartada quando existir tuberculose pulmonar. Seu diagnóstico e tratamento oportuno serão de grande importância para evitar complicações secundárias. Cómo citar: Álvarez-Jaramillo J, Ortiz-Zableh AM, Tarazona-Jiménez P, Ortiz-Azuero A. Hidrocele como manifestación inicial de tuberculosis genitourinaria y miliar. MedUNAB. 2019;22(1):71-78. doi:10.29375/01237047.3534

Tuberculosis miliar con diseminación renal y genitourinaria, Hospital Escuela Universitario, Honduras, 2017 / Tuberculosis Miliar with Renal and Genitourinary Dissemination, University School Hospital. Honduras, 2017

La tuberculosis continúa siendo un reto diagnóstico al presentarse con características clínicas poco usuales. Objetivo: exponer las características clínicas en un caso inusual de tuberculosis miliar, con diseminación genitourinaria. Presentación del caso clínico: p aciente masculino de 48 años, agricultor, de escasos recursos económicos, sin comorbilidades previas; presentó sintomatología constitucional, pérdida de peso, fiebre y dolor lumbar irradiado a ambos flancos de la región abdominal, de características específicas, de un mes de evolución, acompañado de disuria y oliguria, negó síntomas respiratorios. Al examen físico, luce crónicamente enfermo, en mal estado nutricional, sin deterioro de la conciencia, no evidenció adenopatías cervicales ni inguinales, sin presencia de signos pulmonares y con leve dolor renal bilateral a la puño percusión;en área genital se identifica una masa de borde regular, móvil, sobre el polo superior del testículo derecho. Examen hematológico, presencia de Bicitopenia (anemia microcitica hipocromica y trombocitopenia leve). Además con hiperazoemia e hiperkalemia en la bioquímica sanguínea refractaria al tratamiento; en gases arteriales acidosis metabólica con anión gap elevado, por lo que fue sometido a hemodiálisis aguda. A través de los estudios imagenológicos, por medio de la bacteria alcohol acido resistente de sedimento urinario seriado y la tinción Ziehl Neelsen en orina, se determinó el diagnóstico yse inició terapia antifimica. Conclusión: Es necesario considerar a la tuberculosis como diagnóstico diferencial, especialmente en presentaciones poco usuales, dado que es endémica en Honduras...(AU)

Retroperitoneal laparoscopic nephroureterectomy with distal and intramural ureter resection for a tuberculous non - functional kidney

ABSTRACT Objective: To evaluate the safety and feasibility of total retroperitoneal laparoscopic nephroureterectomy with urinary-bladder junction resection for a tuberculous nonfunctional kidney. Materials and Methods: A total of 27 individuals diagnosed with unilateral nonfunctional kidney secondary to tuberculosis were treated between June 2011 and June 2015. All patients had normal renal function on the contralateral side and underwent the standard four-drug anti-tuberculosis treatment for at least four weeks before surgery. Total retroperitoneal laparoscopic nephroureterectomy was performed in all patients, and the urinary-bladder junction of distal ureter was managed using different auto-suture techniques. Results: Nineteen male and 8 female patients with an average age of 47.3 years (range, 36-64 years) underwent surgery. All the operations were successfully performed without conversion. The median operative time was 109.3 min (range, 75-138 min), the median blood loss was 157.5 mL (range, 70-250 mL), and the median hospitalization time was 3.7 days (range, 3-6 days). No serious perioperative complications occurred. Anti-tuberculosis chemotherapy was prescribed to all patients, with the entire course of treatment lasting six months. No recurrence of tuberculosis of the bladder or the contralateral kidney was observed during the median follow-up period of 26.7 months (range, 6-54 months). Conclusion: Retroperitoneal laparoscopic nephroureterectomy with urinary-bladder junction resection is a safe and feasible approach for the treatment of tuberculous non-functional kidneys.

Retroperitoneal laparoscopic nephroureterectomy with distal and intramural ureter resection for a tuberculous non - functional kidney.

OBJECTIVE: To evaluate the safety and feasibility of total retroperitoneal laparoscopic nephroureterectomy with urinary-bladder junction resection for a tuberculous non-functional kidney. MATERIALS AND METHODS: A total of 27 individuals diagnosed with unilateral non-functional kidney secondary to tuberculosis were treated between June 2011 and June 2015. All patients had normal renal function on the contralateral side and underwent the standard four-drug anti-tuberculosis treatment for at least four weeks before surgery. Total retroperitoneal laparoscopic nephroureterectomy was performed in all patients, and the urinary-bladder junction of distal ureter was managed using different auto-suture techniques. RESULTS: Nineteen male and 8 female patients with an average age of 47.3 years (range, 36-64 years) underwent surgery. All the operations were successfully performed without conversion. The median operative time was 109.3 min (range, 75-138 min), the median blood loss was 157.5 mL (range, 70-250 mL), and the median hospitalization time was 3.7 days (range, 3-6 days). No serious perioperative complications occurred. Anti-tuberculosis chemotherapy was prescribed to all patients, with the entire course of treatment lasting six months. No recurrence of tuberculosis of the bladder or the contralateral kidney was observed during the median follow-up period of 26.7 months (range, 6-54 months). CONCLUSION: Retroperitoneal laparoscopic nephroureterectomy with urinary-bladder junction resection is a safe and feasible approach for the treatment of tuberculous non-functional kidneys.

Tuberculosis miliar con diseminación renal y genitourinaria: reporte de un caso / Miliary tuberculosis, with renal and genitourinary disemination; Case Report

Antecedentes: A pesar de los grandes avances en la medicina contemporánea; la Tuberculosis continúa siendo un reto diagnóstico, en especial al presentarse con características clínicas poco usuales. Caso clínico: Paciente masculino de 48 años, agri-cultor, de escasos recursos económicos, sin comorbilidades previas, el cual presenta sintomatología constitucional, pérdida de peso, iebre y dolor lumbar irradiado a ambos lancos de la región abdominal, de características poco especíicas, de un mes de evolución; acompañado de disuria y oliguria, y niega síntomas respiratorios. Al examen físico luce crónicamente enfermo, en mal estado nutricio-nal, sin deterioro de la conciencia, no se evidencia adenopatías cervicales ni inguinales; sin presencia de signos pulmonares, con leve dolor con la puño percusión renal bilateral, en el área genital, se identiica una masa de borde regular, móvil sobre el polo superior del testículo derecho. En el examen hematológico con presencia de Bicitopenia anemia microcitica hipocromica y trombocitopenia leve, en gases arteriales acidosis metabólica con Anión Gap elevado, además con hiperazoemia e hiperkalemia en la bioquímica sanguínea refractaria al tratamiento, razón por la cual fue sometido a Hemodiálisis aguda. Al evaluar radiografía de tórax se observa patrón micro-nodular difuso, no se realiza baciloscopias por falta de expectoración ni por lavado gástrico, en el ultrasonido renal y de vías urinarias se visualizó nefromegalia y la presencia de masa heterogénea de aspecto granulomatoso en testículo derecho; por lo que se solicitó tomografía toracoabdominal, en donde se observa patrón micronodular múltiple a nivel pulmonar, con afectación renal, ganglionar y testicular, se solicita BAAR de sedimento urinario seriado con resultados positivos, y la tinción Ziehl Neelsen en orina con resultado positivo; con ello se inicia terapia antiimica. Discusión: La Tuberculosis renal no tiene un cuadro clínico clásico; generalmente se presenta con manifestaciones atípicas; como en nuestro caso con sintomatología urinaria, hiperazoemia que culmino en terapia de restitución renal de emergencia, con posterior recuperación de la función renal.

Abordagem diagnóstica da tuberculose pleural, ganglionar, renal e de sistema nervoso central / Diagnostic Approach to Tuberculosis in the Pleura, Lymph Nodes, Kidneys, and Central Nervous System

O objetivo do presente artigo foi relatar a abordagem diagnóstica da tuberculose pleural, ganglionar, renal e do sistema nervoso central. A forma mais frequente entre essas formas de tuberculose no Brasil é a tuberculose pleural, cujo diagnóstico na prática clínica baseia-se no exame histopatológico, com uma alternativa relatada nos últimos anos: a dosagem da enzima adenosina desaminase. A maioria dos achados laboratoriais encontrados implica na condição paucibacilar dessas formas extrapulmonares

The objective of this study was to report the diagnostic approach to tuberculosis of the pleura, lymph nodes, kidneys, and central nervous system. In Brazil, the most common extrapulmonary form of tuberculosis is that afecting the pleura. In clinical practice, pleural tuberculosis is typically diagnosed on the basis of the histopathological examination. However, in recent years, the determination of adenosine deaminase levels has been used as an alternative. Most laboratory indings indicate that these extrapulmonary forms are paucibacillary

Diagnóstico bacteriológico de tuberculosis renal: experiencia del Laboratorio Regional de Tuberculosis de la provincia de Córdoba

Dada la considerable incidencia de tuberculosis renal entre enfermos con tuberculosis pulmonar, nos propusimos estudiar la frecuencia de esta asociación en pacientes atendidos en centros de salud públicos y privados de Córdoba a lo largo del período 1997-2009. Se tomó en consideración la incidencia según el sexo y las especies del complejo Mycobacterium tuberculosis identificadas. El análisis de 948 muestras de orina de 383 pacientes indicó tuberculosis renal en 24 casos (6,3 %), con presencia mayoritaria de Mycobacterium tuberculosis (95,8 %) y presencia de Mycobacterium bovis en 4,2 % de los casos. La asociación tuberculosis renal-tuberculosis pulmonar activa se encontró en 6 casos. En esta investigación quedó demostrada la importancia del cultivo seriado de muestras de orina y la conveniencia de cultivar en medios sólidos y líquidos. Asimismo, el aislamiento de Mycobacterium bovis pone de relieve la importancia de usar el medio Stonebrink junto con el medio de Lowenstein-Jensen. El medio líquido no tuvo un aporte significativo al diagnóstico de tuberculosis renal; sin embargo, el cultivo de muestras seriadas aumentó la sensibilidad de la detección.

Bacteriological diagnosis of renal tuberculosis: an experience at the Regional Tuberculosis Laboratory in Córdoba province, Argentina. Given the incidence of renal tuberculosis in patients suffering of pulmonary tuberculosis, we seek to study both the frequency of this association in diagnosed cases of renal tuberculosis and the Mycobacterium tuberculosis complex species that were identified (period 1997-2009), observing its incidence by sex, demonstrating the importance of serial culture of urine samples and evaluating the convenience of using solid and liquid media. The analysis of urine samples from 383 patients indicated renal tuberculosis in 24 cases; in most cases, (95.8 %) Mycobacterium tuberculosis complex species prevailed, whereas the presence of Mycobacterium bovis accounted for 4.2 % of the cases. The association of pulmonary and renal tuberculosis was found in 6 cases. The isolation of Mycobacterium bovis indicates the importance of including Stonebrink medium along with Lowenstein- Jensen medium. The liquid medium made no significant contribution to the diagnosis of renal tuberculosis, but indeed, cultivating serial samples increases sensitivity.

Imágenes en tuberculosis abdominal / Imaging in tuberculosis abdominal

En este artículo se discuten e ilustran las características por imagen de la afectación abdominal por tuberculosis. Se presenta un grupo de pacientes evaluados a través de diferentes modalidades diagnósticas con síntomas abdominales y hallazgos imaginológicos sugestivos de infección granulomatosa. Este diagnóstico fue confirmado posteriormente en la evolución clínica y con estudio histológico. Se incluyen casos de afectación en diferentes órganos abdominales, como sistema linfático, peritoneo, órganos pélvicos, hígado, bazo, riñones y uréteres.

In this article we illustrate and discuss imaging features resulting from Tuberculosis abdominal affectation. We present patients evaluated with several imaging modalities who had abdominal symptoms and findings suggestives of granoulomatous disease. Diagnosiswas confirm including hystopatology and clinica outgoing. Cases involved presented many affected organs such as lymphatic system, peritoneum, liver, spleen, pancreas, kidneys, ureters, adrenal glands and pelvic organs.

Diagnosis and treatment of renal tuberculosis / 中华泌尿外科杂志

Objective To research the clinical manifestations of renal tuberculosis and improve the diagnosis and treatment of renal tuberculosis. Methods From 1993 to 2007,223 cases of renal tuberculosis were hospitalized. Retrospective analysis was complied for all the cases about age, clinical manifestations, imaging and treatment. Results The incidence rates of the renal tuberculosis were obviously higher in the 20-40 years old(41.7%) and in the 41-54 years old (36.3%). The course of this disease was from 1 day to 30 years(mean 38. 5 months). Only 36 patients (16.1%) were made a definite diagnosis when they went to see a doctor primary. The miediagnosis of urinary tract infec-tions( 50.3%) was most frequent. The clinical manifestations of most patients included frequency(54.7%), urgency(50.2%), odynuria(42.2%)and hematuria(58.7%). About 58. 3% patients pres-ented with over 3 kinds of above manifestations. The positive yield of the tuberculin test in urine was only 41.9%. The positive diagnostic rate of renal tuberculosis was only 35.7% in KUB+IVU,72.2%in Type-B Ultrasonic, 76.0% in CT test. One hundred and seventy-three cases were performed with nephrectomy(78.6%) and partial nephrectomy(21.4%). Two cases were treated with dialysis due to uremia. Standard medication was taken for the other 48 patiernts, and effective for 41 cases. Conclu-sions The incidence of atypical renal tuberculosis is increasing. More attention must be paid especially to those patients with urinary infection.

Evaluation of multi-slice spiral CT in the diagnosis of renal tuberculosis / 中华泌尿外科杂志

Objective To evaluate the diagnostic value of multi-slice spiral CT urography (MSCTU)in kidney tuberculosis. Methods Thirty cases(16 men and 14 women)of kidnev tuberculosis diagnosed by clinic and pathology were retrospectively analyzed.The patients' mean age was 44 years(range,19-73 years).Of them,17 cases were on the left and 13 on the right.Eighteen cases had irritation symptoms,18 cases had low back pain,6 cases had hematuria,2 cases had a fever; renal tuberculosis was incidentally detected in 2,1 case had left scrotal swelling.The enhancement scanning and three-dimensional reconstruction of multi-slice spiral CT were conducted in all patients. Resuits Among the 30 cases,29 cases of renal tuberculosis were diagnosed with CTU(97%).The low density area in renal parenchyma was seen in 25 cases without expansion and fluidify of pelvis,tubercle calcification was seen in 18 cases,the thickening of renal pelvis and ureter wall was seen in 17 cases,the thinning of cortex of kidney was seen in 12 cases,and the contracture of bladder and poor filling was seen in 2 cases.IVU diagnosed 9 cases of renal tuberculosis(30%).Twenty cases of renal pelvis,calyceal failed to show contrast filling. Conclusion MSCTU has advantages in the diagnosis of renal tuberculosis compared with IVU.

Urogenital tuberculosis: update and review of 8961 cases from the world literature.

The AIDS epidemic caused unexpected worldwide levels of tuberculosis, even in developed countries where the incidence used to be low. Patients with urogenital tuberculosis in developed countries have fewer specific symptoms and lower rates of delayed diagnoses compared with patients from other countries. As a result, the disease tends to be less serious, with more patients presenting without significant lesions of the upper urinary tract on diagnosis. These data point to a correlation of the timing of diagnosis with the severity of urogenital tuberculosis. A systematic search for urogenital tuberculosis, regardless of symptoms, is warranted for early detection.

Evaluation of imaging diagnostic methods of the renal tuberculosis / 中国基层医药

Objective To analyze the image findings of renal tuberculosis and evaluate the merits and disad vantages of various imaging diagnostic methods, then choose the most sensitive one. Methods The KUB, IVP, AP and CT findings of 48 patients with renal tuberculosis which had been convinced by operations were evaluated and compared. Results The diagnosis rates of KUB and IVP were 41.7% (20/48), AP of 62.5 % (10/16), CT of 100 % (48/48). The characteristic findings of CT were multiple low density lesions, with "flower petals" shape gath-ered in sections. Conclusion CT has a great value for diagnosing renal tuberculosis.

Application of magnetic resonance imaging in differential diagnosis for tuberculous pyonephrosis and hydronephrosis / 中华全科医师杂志

Objective To probe the value of varied magnetic resonance imaging(MRI) techniques applied in differential diagnosis of tuberculous pyonephrosis from hydronephrosis.Methods Features of MRI,including in T_1WI with/without enhancement,T_2WI,urology MRI and diffusion weighted image(DWI),in seven cases with tuberculous pyonephrosis and 10 cases with hydronephrosis pathologically confirmed were retrospectively analyzed.Results Regular T_1WI and T_2WI could show morphology of the whole kidney,destruction of renal parenchyma and empyema.T_1WI with enhancement could manifest abnormally reinforced walls of pyoid cavity,renal pelvis and calyx and ureter.Urology MRI could show morphology of the whole urinary passage with pathological changes more clearly.Accuracy of these techniques was 84.7%.DWI had the advantage of analyzing diffusion image and ADC map to understand diffusion features of water molecule,and of quantitating ADC value to differentiate tuberculous pyonephrosis from hydronephrosis,with an accuracy of 91.2% combining with DWI and other methods.Conclusion Combined application of varied MRI techniques should be highlighted in differentiation of tuberculous pyonephrosis and hydronephrosis with a higher accuracy of diagnosis.

A clinical study of 281 cases of renal tuberculosis / 中华泌尿外科杂志

Objective To study the diagnosis and treatment of renal tuberculosis (TB). Methods A retrospective study was made on 281 cases. Results Irritation symptoms, hematuria and lumbodynia were the most common symptoms. The positive result of acid-fast stains, urinary TB-PCR, PPD-IgG were 44.5%, 44.1% and 62.5% respectively. The diagnostic accuracy of urography, CT and B-type ultrasonography were 69.1%, 84.3% and 28.3%.105 of the 128 cases have been cured on medicine ( INH + RFP + PZA for 6～8 months ). Nephro-ureterectomy was performed for 145 out of 153 cases (94.8%). Conclusions Combined use of different means of diagnostic technique would help to assess the diagnosis of renal TB especially in atypical cases.IVU is still the first choice for diagnosis and CT scan is helpful.INH,REP and PZA used combinedly yiels satisfactory outcome for early cases.When nephro-ureterectomy is indicated,the involved ureter should be excised as much as possible.

Diagnosis and treatment of renal tuberculosis(report of 52 cases) / 中华泌尿外科杂志

Objective To investigate the clinical manifestations,diagnosis and treatment of renal tuberculosis(TB). Methods This series included 52 patients with renal TB.Of them 36 cases (69%) presented with irritative symptoms.10 cases (19%) had lumbago accompanied by hematuria.6 cases (11%) had renal angina and 6(11%) painless hematuria.B-ultrasonography suggested renal TB in 20 cases and unilateral hydronephrosis in 22 cases;renogram showed that the diseased kidneys had no function in 31 cases.Urinal AFB and tuberculosis PCR(Tb-PCR) were performed in 38 cases,the results were positive in 13(34%)and 21(55%),respectively.27 cases were misdiagnosed to have calculi or inflammation.Treatments consisted of antituberculous chemotherapy in 12 cases (23%)and surgery in 40(77%). Results All of the 12 cases who received medications recovered completely.40 cases undergoing surgery were pathologically diagnosed to have renal TB;of them 5 cases developed ureteral stump syndrome. Conclusions Urine AFB and Tb-PCR remain the primary diagnostic methods before operation.When the non-functioning kidney is resected,the involved ureter should be concomitantly resected as much as possible.