Tuberculosis of urinary system

X-ray diagnostics. Taken three types of x-ray methods of the research: 1) review x-rays of the urinary tract; 2) retrograde pyelography; 3) excretory urography.
When plain radiography is sometimes possible to identify individual or merging between a shade petrifitsirovannye caverns, caseous lesions. They have an irregular shape and jagged edges. Shadows of TB petrifikatov unlike kidney stones are located on the periphery of the kidneys, outside of the Cup-pelvis system.
An important role in the diagnosis of renal tuberculosis plays a retrograde pyelography. Absolutely specific characteristic of tuberculosis is the image of cavities on pyelogram (Fig. 83 and 84) in the form of cavities with irregular shapes eaten contours.

tuberculosis of kidneys
Fig. 83. Tuberculosis of the kidneys. Single cavity, at the upper pole of the kidney. Retrograde pyelogram.

Fig. 84. Multiple cavities in the renal parenchyma (policepersons tuberculosis of the kidneys). Retrograde pyelogram.
tuberculosis of the kidneys and ureter
Fig. 85. Tuberculosis kidney and ureter. The urethra is short and tight, physiological bends it disappeared. Policepersons tuberculosis of the kidneys. Retrograde panoretrograph.

In some cases, for scaring puckering TB tricks or fat replacing them on the retrograde pyelogram found a picture of deformation, pressure or obliteration of individual cups or the renal pelvis. Sometimes renal pelvis, cups and ureter be extended not only on the side of the affected kidney, but on the opposite healthy side.
Infiltration, and scar walls of the ureter lead to rigidity and shortening his ureter loses its physiological bends and looks thickened tense cord (Fig. 85). For tuberculosis ureter characteristic narrow clearance, often alternating with areas expansion (celabrity the ureter). Narrowing often formed in kolapushina and oklaohoma departments of the ureter.
The changes detected excretion by pielografia tuberculosis of the kidneys, the same as when retrograde pielografii, but the clarity of the images less, than at retrograde pielografii. Characteristic of tuberculosis picture is observed only in those cases when kidney function is saved. In recent years, excretory urography, conducted with better technical conditions and with the use of contrast agents containing 2 or 3 stoma iodine molecule that gives a clearer picture.
Where cystoscopy or catheterization ureter is difficult or impossible, excretory urography is particularly important for the diagnosis of tuberculosis.
Contrast cystography sometimes identifies the asymmetry of the bladder, which depends on the infiltration of the wall on the side of the affected kidney. TB changes around the mouth of the ureter may impair making capability. On cystogram here numb contrast fluid in a gap in the ureter - vesicoureteral reflux. With advanced tuberculosis bladder capacity it is considerably reduced, he sharply reduced and deformed.