[Complete vesico-ureteral reconstruction with ileum in a case of genitourinary tuberculosis].
BACKGROUND
Genitourinary tuberculosis represent 3.2% of the possible sites of the disease. The lack of treatment or an inadecuate one may lead to severe complications. We report a case and review thoroughly the literature of genitourinary tuberculosis which needed a complete vesico-ureteral reconstruction.


METHODS
A 39 year old female patient with history of pulmonary tuberculosis who had lumbar pain and left ureterohydronephosis. She required a percutaneous urinary derivation and was diagnosed of tuberculosis by means of the urine culture. 18 months afterwards she had a right renal annulation and a left distal ureteral stenosis. A right nephectomy was performed and the left proximal ureter was desinserted accidentally, 1 cm below the pielo-ureteral junction, which required a permanent nephostomy. Then her bladder became gradually retractile. Because she was a young patient and had bad quality of life a complete reconstruction of her left urinary way was performed with an ileum made neobladder and neoureter. DISCUSSION AND CONCLUSSIONS: Bladder and ureter reconstruction with ileum is a good option in difficult cases of lack or irreversible damage of the urinary way. Vesico-ureteral reconstruction letting urethral miction improves quality of life.
Resina
Raquel González
RG
Servicio de Urología del Hospital Universitario Virgen del Rocío, Sevilla, España. raqgores@yahoo.es
Ruiz
Belén Congregado
BC
López
Rafael A Medina
RA
Romero
Francisco J Torrubia
FJ
D000328:Adult; D005260:Female; D006801:Humans; D007082:Ileum / Q000637:transplantation*; D014401:Tuberculosis, Urogenital / Q000601:surgery*; D014515:Ureteral Diseases / Q000601:surgery*; D001745:Urinary Bladder Diseases / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods