不典型附睾结核31例诊治体会

目的:提高对不典型附睾结核的诊断和治疗水平。方法:回顾性分析我院31例不典型附睾结核,探讨不典型附睾结核的临床特点和诊治方法。结果:本组病例中以附睾无痛性肿块为首发症状约占67.7%(21/31),阴囊坠痛和(或)会阴部不适感占12.9%(4/31);尿路刺激症状占16.1%(5/31);镜下血尿占3.2%(1/31);所有患者均在附睾发现肿块,但未发现附睾以外的结核病灶,手术切除肿块并经病理检查证实为附睾结核。结论:不典型附睾结核发病隐匿,临床症状不明显,易漏诊或误诊,在抗结核治疗的基础上手术治疗是有效的治疗方法,附睾结核预后较好。

Diagnosis and Treatment of Atypical Tuberculosis of Epididymis ( Report of 31 Cases)

Abstract： Objectives： To improve the diagnosis and treatment of atypical tuberculosis of epididymis. Methods：31 patients with atypical tuberculosis of epididymis in our hospital were analyzed rectrospectively, and discussed its clinical features and the methods of diagnosis and treatment. Results：Painless epididymal lumps as initial symptoms for treatment accounted for 67.7％ (21/31), scrotal bearing-down pain and (or) perineal malaise for 12.9％（4/31）, urinary tract irritation for 16.1％（5/31）, microscopic hematuria for 3.3％（1/31）, all patients could be found lumps in the epididymis , however tuberculous lesions beyond epididymis were negative. The lumps were testified for tuberculosis of epididymis by means of postoperative pathological diagnosis. Conclusions：Atypical tuberculosis of epididymis presents chronic stage of latency and inapparent symptoms, which causes missed diagnosis and misdiagnosis. Epididymectomy after initial anti- tuberculous medication is effective and prognosis is rather good.