Renal tuberculosis is commonly found in individuals aged 20 to 40, with a higher prevalence in men compared to women. From the kidneys, tuberculosis can spread to nearby reproductive organs such as the seminal vesicles, epididymis, and fallopian tubes; or to other organs such as the meninges.
Renal tuberculosis involves damage to the parenchyma of one of the two kidneys. The disease occurs when tuberculosis bacteria from the lungs spread through the bloodstream (or from the intestines, bones, or lymph nodes) to the kidneys, causing renal tuberculosis.
Initially, the bacteria damage the kidney parenchyma, then affect the calyx and renal pelvis. From this point, the tuberculosis bacilli spread to the urinary and reproductive systems. The disease begins silently, making it difficult to detect renal damage at the early stages when it reaches the calyx and renal pelvis. In the later stages, symptoms may include frequent urination, especially at night; each time producing only a few drops rather than a steady stream, even when the patient tries their best to push. Patients also experience a burning sensation at the end of urination, with pain radiating through the urinary tract, extending upwards and downwards into the thighs…
Patients often have cloudy urine and may experience hematuria (blood in urine).
Imaging studies using contrast dye reveal changes in the shape of the renal pelvis, calyces, ureters, and bladder. The renal pelvis may appear narrowed, swollen, truncated, flower-shaped, or dilated. The ureters may show areas of both narrowing and dilation. The bladder may be small in capacity with thickened walls. Cystoscopy reveals edematous mucosa, thickened muscle columns; there may be nodules the size of a pinhead or larger, and ulcerative lesions from tuberculosis.
The disease progresses slowly, potentially moving from unilateral renal tuberculosis to bilateral renal tuberculosis. The affected kidney may become hydronephrotic due to narrowed or obstructed ureters and renal pelvis. The bladder may atrophy, leading to urinary retention. Tuberculosis can spread to nearby reproductive organs such as the seminal vesicles, epididymis, fallopian tubes, or other organs like the meninges.
To prevent renal tuberculosis, it is essential to detect and effectively treat pulmonary tuberculosis. Individuals with renal tuberculosis need to rest, avoid heavy labor, maintain a balanced diet rich in nutrients, and adhere to prescribed medical treatments.
Dr. Hoang Anh, Health & Life
