A 23-year-old woman developed progressive obstructive uropathy due to multiple renal infundibular and ureteral strictures while on drug treatment for renal tuberculosis. Communication between isolated upper and mid-pole calyces, and the ureter, was established by percutaneous guidewire manipulation. The strictures were successfully managed using percutaneous balloon catheter dilatation and ureteral stenting without the need for open surgical exploration. Kidney function was preserved at one year follow-up.
The management of the non-functional tuberculous kidney is controversial and ranges from surgical intervention to conservative treatment. Intra-renal scarring with stricture formation is common in the late stages of renal tuberculosis and results in greater loss of renal function than direct involvement by tuberculosis alone.
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