Some Aspects of Urogenital Tuberculosis

Background and aims: urogenital tuberculosis (ugt) is a worldwide disease with non-typical and misleadingclinical features, resulted in late diagnosis. late diagnosed complicated forms of renal tuberculosis (tb) arepoor for standard chemotherapy, the additional pathogenetic therapy is necessary. the aims of the currentstudy were to estimate the epidemiological situation on ugt in the region with high incidence rate and to valuethe efficiency of the complex etiopathogenetic therapy for bladder tb.methods: estimates of extrapulmonary tuberculosis incidence and its structure in siberia have been made onthe basis of the data available in official reporting forms no 8 (approved by resolution no 175 of the russianstatistics agency 11 november, 2005).in addition, 102 patients with bladder tb were enrolled in study: 76 were treated with standard tetrad(isoniazid + streptomycin + pyrazinamid + rifampicin), and 26 received modified tetrad in combination withtrospium chloride.results: during the last 5 years the incidence of tb maintains stable high in siberia, and in 2008 it raised upto 139.6 per 100000 habitants. ugt was the prevalent form (46.0 – 33.5%); tb of bone and joints was in thesecond place (20.1 – 32.7%), this was followed by lymphonodal tb (14.7 – 14.9%).standard chemotherapy had poor efficiency for bladder tb: only 42.1% could be cured, 57.9% developedcomplications such as posttuberculous cystalgia (36.8%) and microcystis (21.1%). in patients received thecombined treatment outcome was favourable: urinary frequency reduced about 75%, bladder capacityincreased an average of 4.7 fold. none of these patients developed true microcystis.conclusions: in siberia, there is an epidemic of tb. ugt is the most common form among extrapulmonarytb. standard chemotherapy for bladder tb demonstrated poor results, but combination chemodrug plustrospium chloride was more effective and should be recommended to all patients with bladder tb grade 2-3.