rifampin and Constriction--Pathologic

On the basis of a series of 86 cases of urogenital tuberculosis and a review of literature, a detailed study of the different therapeutic methods of this affection is done. Today, with the tuberculostatic agents, the medical treatment alone is frequently sufficient and ablative surgery is less often mandatory than reconstructive. Different types of short course chemotherapy and the role of associated steroids are reviewed. Finally, the authors stress the indications of ablative surgery and review the different procedures of reconstructive surgery in order to clearly define a logical therapeutic approach.

Topics: Adolescent; Adrenal Cortex Hormones; Adult; Aged; Aged, 80 and over; Antitubercular Agents; Constriction, Pathologic; Endoscopy; Female; Humans; Isoniazid; Male; Middle Aged; Nephrectomy; Pyrazinamide; Rifampin; Streptomycin; Tuberculosis, Urogenital; Ureter; Ureteral Diseases; Ureteroscopy

Bronchoscopic balloon dilation is a common method in the treatment of bronchostenosis but it is not an effective treatment due to its short dilating time (3 minutes) and low pressure (<3atm). Until recently, the reported highest dilating pressure was ≤6atm; however, this is not enough pressure to dilate a bronchostenosis because of the resistance of the bronchus. We hypothesized that higher dilating pressure (up to 14atm) with longer dilating time (40 minutes) may make bronchoscopic balloon dilation treatment more effective according to the blood vessel dilating method. Therefore, we designed this new bronchoscopic balloon dilation method for treating bronchostenosis, particularly in cases caused by bronchial tuberculosis.. A 23-year-old Chinese woman presented with right middle segmental bronchostenosis caused by bronchial tuberculosis. She was informed of the surgical procedure and she provided informed consent. After taking anti-bronchial tuberculosis drugs for 2 months, she underwent our new bronchoscopic balloon dilation treatment (dilating time, 40 minutes; pressure, 14atm). After anti-bronchial tuberculosis treatment for 13 months, her intermediate bronchus was observed with videobronchoscopy again and no re-stenosis was seen. Furthermore, a computed tomography scan revealed that her right lower lobe and right middle lobe had reopened. No complications occurred in the patient.. The novel high-handed videobronchoscopic balloon dilation method was safe and effective for treating this patient with bronchostenosis caused by bronchial tuberculosis.

Topics: Antitubercular Agents; Bronchial Diseases; Bronchoscopy; Constriction, Pathologic; Dilatation; Ethambutol; Female; Humans; Isoniazid; Lung; Pyrazinamide; Radiography; Rifampin; Treatment Outcome; Tuberculosis, Pulmonary; Young Adult

Tuberculous ureteral stricture causing progressive obstructive uropathy commonly complicates renal tuberculosis. The aim of our study was to evaluate the effectiveness of early ureteral stenting or percutaneous nephrostomy (PCN) in patients with tuberculous ureteral strictures.. Seventy-seven patients (84 renal units) with tuberculous ureteral strictures were analyzed. We evaluated the final outcome of involved kidneys with three different managements: medication only (N = 37), medication plus ureteral stenting (N = 28), or medication plus PCN (N = 19).. The overall nephrectomy rate was 51%. In patients treated with medication only, the nephrectomy rate was 73%, whereas the nephrectomy rate was 34% in patients treated with medication plus early ureteral stenting or PCN. The rate of reconstructive surgery for ureteral strictures also was significantly different for patients treated with medication only (8%) and those receiving medication plus early ureteral stenting or PCN (49%). Spontaneous resolution of the strictures was noted in 6 of the 12 renal units that were managed with early ureteral stenting.. Early ureteral stenting or PCN in patients with tuberculous ureteral strictures may increase the opportunity for later reconstructive surgery and decrease the likelihood of renal loss.

Topics: Adolescent; Adult; Aged; Antibiotics, Antitubercular; Antitubercular Agents; Chi-Square Distribution; Constriction, Pathologic; Drug Therapy, Combination; Ethambutol; Female; Humans; Isoniazid; Male; Middle Aged; Nephrectomy; Nephrostomy, Percutaneous; Rifampin; Stents; Time Factors; Treatment Outcome; Tuberculosis, Renal; Ureter; Ureteral Obstruction

A 23-year-old woman developed progressive obstructive uropathy due to multiple renal infundibular and ureteral strictures while on drug treatment for renal tuberculosis. Communication between isolated upper and mid-pole calyces, and the ureter, was established by percutaneous guidewire manipulation. The strictures were successfully managed using percutaneous balloon catheter dilatation and ureteral stenting without the need for open surgical exploration. Kidney function was preserved at one year follow-up.

Topics: Adult; Antitubercular Agents; Catheterization; Constriction, Pathologic; Female; Follow-Up Studies; Humans; Isoniazid; Kidney Calices; Kidney Pelvis; Nephrostomy, Percutaneous; Pyridoxine; Rifampin; Stents; Tuberculosis, Renal; Ureteral Diseases

The authors report a series of 40 cases of genitourinary tuberculosis diagnosed and treated in the department of urology "B" of Avicenne hospital over a 7-year period. The objective of this study is to define the various diagnostic and therapeutic aspects of this disease. The patients were predominantly males (62.5%) with a mean age of 40 years. 25% of cases reported a history of extra-urinary tuberculosis. The very polymorphous clinical presentation is dominated by signs of cystitis (45%). Intravenous urography is frequently suggestive of the diagnosis based on the appearance and multiplicity of the lesions. The radiological lesions most frequently encountered were silent kidney (19 cases) and small tuberculous bladder (11 cases). The definitive diagnosis was established by pathological examination in 38 cases (biopsies, operative specimens, prostatic resection chips) and/or by demonstration of AFB in 2 cases (urine, pus). Tuberculostatic treatment was administered to all patients, either alone (5 cases) or, more usually, in combination with surgical and/or endo-urological treatment (35 cases), reflecting the magnitude and severity of the destructive and scar lesions.

Topics: Adolescent; Adult; Aged; Antibiotics, Antitubercular; Antitubercular Agents; Biopsy; Combined Modality Therapy; Constriction, Pathologic; Cystitis; Female; Humans; Isoniazid; Male; Middle Aged; Mycobacterium tuberculosis; Nephrectomy; Prostatic Diseases; Pyrazinamide; Rifampin; Stents; Tuberculosis, Male Genital; Tuberculosis, Renal; Tuberculosis, Spinal; Tuberculosis, Urogenital; Ureteral Diseases; Urinary Bladder Diseases; Urography

Tuberculosis of the rectum is rarely reported, even from areas where tuberculosis, and gastrointestinal tuberculosis in particular, is prevalent. The authors report a case of long tubercular stricture of the rectum and distal part of the sigmoid colon in a 12-year-old girl. Because of nonspecific symptoms and noncharacteristic radiological and endoscopic features, the diagnosis of this rare entity rests mainly on histological evidence of the classical tubercle in a surgical biopsy specimen.

Topics: Antitubercular Agents; Child; Colectomy; Constriction, Pathologic; Ethambutol; Female; Humans; Isoniazid; Rectal Diseases; Rifampin; Sigmoid Diseases; Tuberculosis, Gastrointestinal

Topics: Constriction, Pathologic; Female; Humans; Isoniazid; Middle Aged; Rifampin; Tracheitis; Tuberculosis, Pulmonary