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首页> 外文期刊>Nature reviews. Urology >Urogenital tuberculosis - epidemiology, pathogenesis and clinical features
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Urogenital tuberculosis - epidemiology, pathogenesis and clinical features

机译：泌尿生殖器结核 - 流行病学，发病机制和临床特征

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摘要

Tuberculosis (TB) is the most common cause of death from infectious disease worldwide. A substantial proportion of patients presenting with extrapulmonary TB have urogenital TB (UG-TB), which can easily be overlooked owing to non-specific symptoms, chronic and cryptic protean clinical manifestations, and lack of clinician awareness of the possibility of TB. Delay in diagnosis results in disease progression, irreversible tissue and organ damage and chronic renal failure. UG-TB can manifest with acute or chronic inflammation of the urinary or genital tract, abdominal pain, abdominal mass, obstructive uropathy, infertility, menstrual irregularities and abnormal renal function tests. Advanced UG-TB can cause renal scarring, distortion of renal calyces and pelvic, ureteric strictures, stenosis, urinary outflow tract obstruction, hydroureter, hydronephrosis, renal failure and reduced bladder capacity. The specific diagnosis of UG-TB is achieved by culturing Mycobacterium tuberculosis from an appropriate clinical sample or by DNA identification. Imaging can aid in localizing site, extent and effect of the disease, obtaining tissue samples for diagnosis, planning medical or surgical management, and monitoring response to treatment. Drug-sensitive TB requires 6-9 months of WHO-recommended standard treatment regimens. Drug-resistant TB requires 12-24 months of therapy with toxic drugs with close monitoring. Surgical intervention as an adjunct to medical drug treatment is required in certain circumstances. Current challenges in UG-TB management include making an early diagnosis, raising clinical awareness, developing rapid and sensitive TB diagnostics tests, and improving treatment outcomes.
机译：结核病（TB）是全世界传染病死亡最常见的死亡原因。大量患有外胰蛋白结核病的患者具有泌尿生殖器结核病（UG-TB），由于非特异性症状，慢性和神秘的临床表现，缺乏临床医生对TB可能性的意识，可以容易地忽略。延迟诊断导致疾病进展，不可逆组织和器官损伤和慢性肾功能衰竭。 UG-TB可用急性或慢性炎症表现出尿或生殖道，腹痛，腹部肿块，阻塞性激病，不孕症，月经不规则性和异常肾功能试验。先进的UG-TB可引起肾脏瘢痕，肾脏疤痕，骨盆，输尿管狭窄，狭窄，尿液流动梗阻，循环，肾内肾，肾功能衰竭和降低膀胱容量。通过从适当的临床样本或DNA鉴定培养结核分枝杆菌或通过DNA鉴定来实现UG-TB的特异性诊断。成像可以有助于本地化现场，疾病的程度和效果，获得组织样品用于诊断，规划医疗或外科管理，以及监测对治疗的反应。药物敏感的TB需要6-9个月的谁推荐的标准治疗方案。耐药TB需要12-24个月的治疗，毒性药物具有密切监测。在某些情况下需要手术干预作为医疗药物治疗的辅助。 UG-TB管理中的当前挑战包括提前诊断，提高临床意识，开发快速和敏感的结核病诊断测试，以及改善治疗结果。

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