Figure 1
cytitis and right acute renal colic in a 44 year-old woman
urinary tuberculosis
A 44 year-old woman was referred to the radiology department for imaging of the urinary tract. She presented with symptoms of recurrent cystitis. Cystoscopy was first performed. Swollen mucosa was found. Biopsies were performed which revealed granulomatosis consistent with tuberculosis. Quadruple-agent tuberculostatic therapy was started. CT (not shown)showed no stone and non specific uretero-hydronephrosis. During treatment, an episode of right acute renal colic occurred. Plain radiograph of the abdomen and an IVU were then performed. Thereafter, right distal ureteric stenosis was removed and psoas hitch was performed.
Urinary tract is the second most common site of tuberculosis (TB) after lung. It results from hematogenous spread. Unilateral involvement is the rule. The male/female ratio is 3:1 (1).Clinical findings of urinary TB are usually frequency, urgency, dysuria associated with gross or microscopic hematuria and/or sterile pyuria (2). Acute renal colic is not rare. Intravenous urography (IVU) remains a valuable tool for both diagnosis and follow-up (2, 3). IVU allows both qualitative evaluation of renal function and an overall view of the urinary tract. The obtained contrast depends on two factors : the amount of remaining functional parenchyma, and the degree of obstruction (4). TB involves the entirety of urinary tract (from the kidney to the urethra) that IVU is able to show. Moreover, during IVU, peristalsis of ureters and kinetics of bladder voiding can be fluoroscopically studied. At least, IVU can be easily repeated and compared during follow-up.
References
[1] Kirchner TH. Kirchner J. Jacobi V. [Renal parenchymal defects as signs of renal tuberculosis]. [German] Rontgenpraxis. 52(10-12):332-4, 2000. (PMID: 20262389)
[2] Mnif A. Loussaief H. Ben Hassine L. Chebil M. Ayed M. [Aspects of evolving urogenital tuberculosis. 60 cases]. [French] Annales d Urologie. 32(5):283-9, 1998. (PMID: 99044442)
[3] el Khader K. el Fassi J. Karmouni T. Tazi K. Ibnattya A. Hachimi M. Lakrissa A. [Urogenital tuberculosis. Apropos of 40 cases]. [French] Annales d Urologie. 31(6-7):339-43, 1997. (PMID: 98169971)
[4] Ramanathan R. Kumar A. Kapoor R. Bhandari M. Relief of urinary tract obstruction in tuberculosis to improve renal function. Analysis of predictive factors. British Journal of Urology. 81(2):199-205, 1998 Feb. (PMID: 98147382)
Case information
| URL: | https://www.eurorad.org/case/779 |
| DOI: | 10.1594/EURORAD/CASE.779 |
| ISSN: | 1563-4086 |
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