男性生殖系结核的诊断与治疗

目的 :探讨男性生殖系结核的诊断与治疗。　方法 :对 15例经病原学或病理学证实的男性生殖系结核患者的诊断、鉴别诊断及治疗进行回顾性分析。　结果 :结合病史、体格检查、精液抗酸杆菌镜检或抗酸杆菌培养和手术标本病理检查可确诊。其中 ,1例为肾结核并发附睾、睾丸结核 ,1例为肾结核并发结核性精囊炎 ,8例为原发性单纯附睾结核 ,5例为原发性附睾、睾丸结核。 4例单纯抗结核药物治疗 ,11例手术治疗。　结论 :男性生殖系结核呈现非典型化趋势 ,精液TB PCR可能为男性生殖系结核的诊断提供了新的途径 ,必要时组织活检可确诊。手术治疗应慎重 ,尤其是对年轻患者。

Diagnosis and Treatment of Tuberculosis in the Male Genital System

Objective: To probe into and improve the diagnosis and treatment of tuberculosis (TB) in the male genital system. Methods: Fifteen patients with the male genital system TB established by microbiological and pathological examinations were retrospectively reviewed. Results: The male genital system TB was diagnosed by history, physical examination, semen analysis, TB culture and biopsy. Treatment consisted of antituberculous chemotherapy for all the patients before and/or after operation, including 5 cases of epididymectomy and 6 cases of orchi-epididymectomy. Conclusion: The male genital system TB tends to be atypical and semen polymerase chain reaction of TB (TB-PCR) may provide a new specific means for diagnosis in case of clinical suspicion. Surgical approaches should be cautiously adopted, especially for young patients.