Clinical features of tuberculous bladder contracture: An analysis of 32 cases

Objective To analyze the clinical characteristics of tuberculous bladder contracture and provide ideas for the prevention and treatment of bladder contracture. Methods In the study, 32 cases with contracture bladder admitted to our hospital from 2009 to 2015 were enrolled.There were 17 males and 15 females with age ranging from 17-73 years, and their clinical data, past history, clinical symptoms, cystoscopy results, late complications, treatment and pathological examinations were retrospectively reviewed. Results The disease course of 32 patients with bladder contracture complicating urinary tract tuberculosis was 1.5-11 years, of which 11 cases with double kidney tuberculosis, 20 patients with unilateral renal tuberculosis and 1 case with simple tuberculous bladder contracture.Of the 32 patients with bladder contracture, 18 had a previous history of pulmonary tuberculosis.Ten patients had been diagnosed as urinary tuberculosis within 1 year after occurrence of bladder irritation symptoms.Twenty-two patients were diagnosed in more than 1 year, and they were misdiagnosed as cystitis (n=15), prostatitis (n=5), urinary calculi (n=1), glandular cystitis (n=1).Lower urinary tract symptom was the main clinical manifestation of bladder contracture.Of the 7 cases undergoing cystoscopy with significantly reduced bladder capacity, 5 cases had slit-like opening of bladder ureter, 3 cases showed pale bladder mucosa, 4 cases showed nonspecific cystitis performance, and the pathology results of cystoscopic examination indicated acute and chronic bladder inflammation.Eleven patients underwent sigmoid augmentation cystoplasty, and 8 cases with preoperative renal puncture fistulization.Postoperative pathology reports showed that bladder transitional cell layers became thinner in 9 cases (81.8%), muscle layer of fibrous connective tissue hyperplasia was found in 11 cases (100%), 2 cases with tuberculousgranuloma (11.8%) and acid fast staining was positive in 1 case (9.1%). Conclusion Urinary tract tuberculosis lacks of early specific clinical manifestation and misdiagnosis or mistreatment are still the key factors leading to the occurrence of bladder contracture.Bladder augmentation with sigmoid colon is also needed for contracture bladder patients.