Objective: To summarize the results of 8 consecutive laparoscopic nephroureterectomies (LNUs)
for tuberculous nonfunctioning kidneys and compare them with 10 LNUs performed for other benign
etiologies (control group).
Materials and Methods: From November 1999 to February 2004, 8 patients underwent LNU for
tuberculous ureteric stricture with a nonfunctioning kidney at our center. During the same time period,
10 LNUs were performed for other benign conditions. Hospital records were reviewed to obtain
demographic data. In addition, operative time, intraoperative and postoperative complications,
duration of postoperative ileus, and hospital stay was recorded. The outcomes of surgery for tuberculosis
were compared with that for the control group. Patients were followed up for long-term
complications of laparoscopic surgery.
Results: The two groups had a comparable demographic data. Nephroureterectomy was successfully
performed laparoscopically in all 8 patients with tuberculosis. One patient in the control group,
with a large staghorn renal and ureteral calculus, required conversion to open surgery due to dense
perinephric adhesions. The outcome of surgery for tuberculosis was compared with outcomes in the
control group using SPSS software. The mean operative time, blood loss, analgesic requirement, duration
of postoperative ileus, and hospital stay of both groups was comparable, and the differences
between them were statistically insignificant.
Conclusion: The results of this study indicate that LNU for a tuberculous nonfunctioning kidney
is a safe, effective, and less invasive treatment modality. Comparing our results with those of
nephroureterectomy for other, benign diseases shows that the procedure has similar safety and efficacy
even for tuberculous kidneys. Tuberculosis should not be considered a contraindication for
a laparoscopic approach. Laparoscopic nephroureterectomy should be offered as the treatment
modality of choice to all patients with tuberculous nonfunctioning kidney whose disease involves the
kidney and ureters.
