Why should a non-functioning kidney with renal tuberculosis be removed?

   In patients with renal tuberculosis, after about six months to one year of treatment with anti-tuberculosis internal medicine, the patient’s symptoms disappear, the blood sedimentation normalizes, and he resumes normal work. In other patients, the affected kidney loses its function because of tuberculosis. Because the affected kidney is calcified and encapsulated because of tuberculosis (for example, picture 1 of the specimen of the patient we operated on), a tuberculous pus cavity (white cheese-like) is formed (for example, picture 2 of the specimen of the patient we operated on), and tuberculosis bacteria are present inside, anti-tuberculosis drugs cannot reach it, so the kidney that has lost its function must be surgically removed.  Because once there is renal TB, there is often a combination of ureteral and bladder TB, and TB bacilli can be present in the areas of the above organs, radical hemiureterectomy (including removal of the kidney, ureter, and bladder cuff) is required to completely destroy any TB bacilli that may remain.  Conventional radical hemiureterectomy (including nephrectomy, ureterectomy, and cystectomy) involves incision of two incisions of 25 cm and 20 cm each in the lumbar region and lower abdomen, which results in a long operative time, extensive injury, and painful prognosis. We use transurethral laser bladder cuff resection first, then laparoscopic resection of the lost kidney and ureter via the lumbar area, then a small incision in the lower abdomen to deal with the lower ureter, and complete removal of the kidney, ureter, and bladder cuff through this incision, which is short, less invasive, and aesthetically pleasing.  Laparoscopic combined with minimally invasive transurethral laser radical hemiureterectomy is a very good treatment for non-functional renal tuberculosis.