Abstract

GONZALEZ RESINA, Raquel; CONGREGADO RUIZ, Belén; MEDINA LOPEZ, Rafael A.  and  TORRUBIA ROMERO, Francisco J.. Complete vesico-ureteral reconstruction with ileum in a case of genitourinary tuberculosis. Actas Urol Esp [online]. 2009, vol.33, n.6, pp.706-711. ISSN 0210-4806.

Introduction:Genitourinary tuberculosis represent 3,2% of the possible sites of the disease. The lack of treatment or an inadecuate one may lead to severe complications. We report a case and review thoroughly the literature of genitourinary tuberculosis which needed a complete vesico-ureteral reconstruction. Clinical case: A 39 year old female patient with history of pulmonary tuberculosis who had lumbar pain and left ureterohydronephosis. She required a percutaneous urinary derivation and was diagnosed of tuberculosis by means of the urine culture. 18 months afterwards she had a right renal annulation and a left distal ureteral stenosis. A right nephectomy was performed and the left proximal ureter was desinserted accidentally, 1 cm below the pielo-ureteral junction, which required a permanent nephostomy. Then her bladder became gradually retractile. Because she was a young patient and had bad quality of life a complete reconstruction of her left urinary way was performed with an ileum made neobladder and neoureter. Discussion and Conclussions: Bladder and ureter reconstruction with ileum is a good option in difficult cases of lack or irreversible damage of the urinary way. Vesico-ureteral reconstruction letting urethral miction improves quality of life.

Keywords : Urinary tuberculosis; Surgical Technique; Cistoplasty; Ureteroplasty.

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