泌尿生殖道结核优秀PPT.ppt

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1、泌尿生殖道结核你现在浏览的是第一页，共34页Tubercle bacilli may invade one or more of the organs of genitourinary tract and cause a chronic granulomatous infection that shows the same characteristic as TB in other organs.你现在浏览的是第二页，共34页60%of patients are between the age of 20-60.A little more common in males than in fem

2、ales你现在浏览的是第三页，共34页 EtiologyMycobacterium tuberculosisLungs-hematogenous-Genitourinary OrgansKidney and prostate-primary sites of TB infection 你现在浏览的是第四页，共34页你现在浏览的是第五页，共34页Pathogenesis&Pathology 1Kidney&UreterThe tubercle bacilli hits the renal cortex.Pathological TB.Clinical TB.TB granulomatous Ca

3、sceation(cheesy Material),CalcificationPelvis,calyces,and ureter-thickend,ulcerationHydronephrosisAutonephrectomy“golf hole”(gaping)你现在浏览的是第六页，共34页 Pathogenesis&Pathology 2BladderThe mucosa may be inflamed.Tubercles UlcerateFibrosed and ContractedUreteral refluxor Stenosis你现在浏览的是第七页，共34页Pathogenesis

4、&Pathology 3ProstateSeminal VesiclesEpidydimis and Testis你现在浏览的是第八页，共34页 Clinical Findings 1Chronic cystitis refuses to respond to therapy.Pyuria without bacteria.HematuriaA nontender,enlarged epidydimisA chronic draining scrotal sinusInduration or nodulation of prostate and thickening seminal vesic

5、les你现在浏览的是第九页，共34页 Clinical Findings 2SymptomsVesical irritabillity:burning,frequency,urgency,nocturia,hematuria.Flank pain:dull ache or colicPainless swelling of the epididymis or chronic draining sinus.Nonspecific complaints:persistent fever,night sweats.你现在浏览的是第十页，共34页 Clinical Findings 3SignsEnl

6、argement or tenderness of kidney.External genitallaProstate 你现在浏览的是第十一页，共34页 Laboratory FindingsPersistent pyuriaTubercle bacilli culturesBlood countErythrocyte sedimentation rateRenal functionTuberculin test 你现在浏览的是第十二页，共34页 Imaging 1 Chest filmPlain film of abdomenExcretory urograms:1)“moth-eaten”

7、2)obliteration of calyces 3)dilatation of calyces 4)abscess cavities 5)ureteral strictures,shortening and straightening 6)absence of functional kidney Retrograde urography你现在浏览的是第十三页，共34页你现在浏览的是第十四页，共34页你现在浏览的是第十五页，共34页你现在浏览的是第十六页，共34页你现在浏览的是第十七页，共34页你现在浏览的是第十八页，共34页你现在浏览的是第十九页，共34页 Imaging 2Ultraso

8、nographyCTMRI你现在浏览的是第二十页，共34页 Instrumental examinationCystoscopy “golf-hole”Biopsy你现在浏览的是第二十一页，共34页你现在浏览的是第二十二页，共34页你现在浏览的是第二十三页，共34页你现在浏览的是第二十四页，共34页你现在浏览的是第二十五页，共34页 Differential diagnosis Chronic nonspecific cystitis and pyelonephritisNonspecific epididymitisRenal stonesUrologic tumor你现在浏览的是第二十六页

9、，共34页ComplicationsPerinephric abscessRenal stones HydronephrosisUremia你现在浏览的是第二十七页，共34页 Treatment 1Antituberculosis drugs你现在浏览的是第二十八页，共34页 Treatment 2Chemotherapy 1你现在浏览的是第二十九页，共34页 Treatment 3Chemotherapy 2你现在浏览的是第三十页，共34页 Treatment 4Surgical management Nephrectomy Partial nephrectomy EpididymectomyReconstructive surgery Ureteral stricture Augmentation cystoplasty 你现在浏览的是第三十一页，共34页你现在浏览的是第三十二页，共34页你现在浏览的是第三十三页，共34页 Prognosis你现在浏览的是第三十四页，共34页