单纯性附睾结核的诊治分析

目的:提高对单纯性附睾结核的诊治水平。方法:在35例附睾结核患者中通过尿路影像学检查无肾结核及尿抗酸杆菌检测阴性者,定义为单纯性附睾结核20例进行回顾性分析,均行强化抗结核治疗,即异烟肼(INH)、利福平(RFP)、链霉素(SM)或乙胺丁醇(EB)联合用药,2周后行病灶切除术,术中均行附睾结核病灶清除,术后继续常规抗结核治疗6～9个月。结果:随访6个月～5年,16例无异常情况,3例分别于术后3、3.5、5年出现泌尿系结核感染,1例于术后3.5年出现对侧附睾结核。结论:单纯性附睾结核可能为唯一或早期泌尿生殖系结核首发的表现,及时手术治疗,预后较好。

Diagnosis and Treatment of Isolated Tuberculous Epididymitis

Objective： To improve the diagnosis and the treatment of tuberculous epididymitis. Methods： Retrospective studies were made of 20 eases of isolated epididymal tuberculosis defined as ＂tuberculosis infection affecting the epididymis without evidence of renal involvement as documented by the absence of acid fast bacilli in the urine sample and on imaging＂ among 35 patients with epididymal tuberculosis. Two weeks after the intensified anti-TB treatment by the combined therapy of Isoniazid ＋ Rifampicin ＋ Streptomycin or Ethambutol, all the patients underwent surgical removal of the tuberculous lesion, followed again by the combined therapy for 6-9 months. Results ： Of the 20 cases, 16 experienced no recurrence and complications within 0.5-5 years after the surgery, 3 were found with urinary tuberculosis at 3, 3.5 and 5 years, and 1 developed tuberculous epididymitis of the other side at 3.5 years. Conclusion ： Isolated tuberculous epididymitis may be the sole or the initial presentation of genitourinary tuberculosis, for which timely surgery is the best option and has a good prognosis. Natl J Androl, 2008, 14 （10） ： 917-919