автор: Chavdar Slavov
заглавие: Genitourinary Tuberculosis
Подзаглавие:
година: 2007
ISBN: 978-954-326-038-6
Издател: Парадигма
цена:
40 лв.
Транспортните разходи са за сметка на клиента
Though presently there is no explicit trend of increasing the incidence of genito-urinary tuberculosis (GT), it is expected to rise in the near future because of the specifics of the TBC process. At the same time the advanced stages of the disease are observed more often, which results in a high percentage of organ loss and incapacitation. This provokes the search for more suitable methods of early diagnostics and more effective therapeutic schemes and techniques.
This book encompasses the comprehensive 25 year experience of the author, including evaluation of the implemented new diagnostic methods and update of the classic ones. A substantial portion of this scientific paper is dedicated to the new and modified surgical techniques of organ-sparing and reconstructive operative procedures, introduced in the practice of urology.
The narrative reflects the most advanced achievements of medical science and practice, supported by a large number of reference publications.
This book does not cover only the domain of urologists, but a wider array of medical specialties (nephrologists, phtysiatrics, GPs and others.
From the author
FORWORD...........................................................................................................................5
GENITOURINARYTUBERCULOSIS................................................................................7
HISTORICAL BACKGROUND..........................................................................................9
EPIDEMIOLOGY...............................................................................................................11
PATHOGENESIS................................................................................................................15
PATHOMORPHOLOGICAL CHARACTERISTICS......................................................20
CLINICAL PRESENTATION.............................................................................................24
TUBERCULOSIS OF THE MALE REPRODUCTIVE ORGANS.................................26
I.Tuberculosis of the testicle and epididimis.............................................................................26
II. Tuberculosis of the prostate gland, seminal vesicules and the urethra.......................32
Ill.Tuberculosis of the penis.............................................................................................................34
TUBERCULOSIS OF FEMALE REPRODUCTIVE SYSTEM.......................................36
UROGENITAL TUBERCULOSIS IN CHILDREN..........................................................40
LABORATORY PARAMETERS........................................................................................42
DIAGNOSTICS..................................................................................................................44
I. Microbiological diagnostics.........................................................................................................44
II. Molecular methods of diagnostics............................................................................................46
III. Pathomorphology dianostics....................................................................................................47
IV. X-ray Diagnostics............................................................................................................................48
V. Ultrasound diagnostics..................................................................................................................66
VI.Tuberculine-based and immunological diagnostics.........................................................69
VII. Radionuclear imaging.................................................................................................................71
VIII. Instrumental diagnostics..........................................................................................................74
1. Endourological diagnostics........................................................................................74
2. Biopsy methods...............................................................................................................75
DIFFERENTIAL DIAGNOSIS..........................................................................................76
CLASSIFICATION..............................................................................................................87
GTTREATMENT................................................................................................................89
I.BasicTuberculostatics.....................................................................................................93
II. Tuberculostatics of second line..................................................................................97
THERAPEUTIC SCHEMES...........................................................................................101
Treatment of recurrences...............................................................................................103
Treatment in case of resistant mycobacteria.........................................................103
Reasons for resistance....................................................................................................103
GT treatment of patients with HIV..............................................................................105
GT treatment in patients with overlapping
chronic nonspecific pyelonephritis (CPN)...............................................................107
GT treatment in patients with renal insufficiency.................................................11
GT treatment during pregnancy.................................................................................Ill
CLINICAL MONITORING.............................................................................................112
Prophilaxis with Isoniazid (INH)...........................................................................................113
SURGICAL TREATMENT..............................................................................................114
1.Conservative surgical procedures..........................................................................114
2. Definitive surgical treatment:..................................................................................114
CONSERVATIVE SURGICAL TREATMENT...............................................................116
BALLOON DILATATION OF THE URETER.....................................................................................118
ENDOSCOPIC URETEROTOMY......................................................................................................118
Nephrectomy.....................................................................................................................120
LAPAROSCOPIC NEPHRECTOMIES IN GT...................................................................................122
Partial nephrectomy.......................................................................................................125
RECONSTRUCTIVE OPERATIVE PROCEDURES OF THE URINARYTRACT.........................126
Operative procedures on the ureter..........................................................................127
Extravesical reimplantations........................................................................................128
Intravesical reimplantations.........................................................................................129
Uretero-uretero anastomoses......................................................................................129
"Boari"-flap procedure....................................................................................................130
Intestinal substitution of the ureter...........................................................................132
Operations in PUJ stenoses...........................................................................................133
Dismembered pyeloureteroplastics..........................................................................133
Ureteropyeloplastics with preservation of the PUJ integrity............................135
Ureterocalicoanastomosis.............................................................................................135
Laparoscopic ureteropyeloplastics............................................................................136
Reconstructive operative procedures of the bladder..........................................136
Intravesical distension of the bladder.......................................................................137
Bladder augmentation....................................................................................................139
Orthotopic bladder substitution in GT.....................................................................145
Operative procedures on the male urethra............................................................147
Urethroplasty with preputial flap...............................................................................148
Urethroplasty with longitudinal flap from ventral penile skin.........................150
Urethroplasty with free buccal mucosa graft.........................................................150
CLINICAL FOLLOW UP................................................................................................7 53
References......................................................................................................................154
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