Urologic tuberculosis is a foci of tuberculosis secondary to other parts of the body, most notably the kidney. Among urologic TB, renal TB is the most common and first to occur, and later spreads from the kidney to the entire urinary system. Therefore, renal tuberculosis actually represents the significance of urologic tuberculosis. I. Diagnosis The disease process of renal tuberculosis is very slow, and the clinical manifestations are dominated by bladder irritation symptoms. Therefore, the diagnosis of renal tuberculosis is guided by the symptoms of cystitis (urinary frequency, urinary urgency, and urinary pain). In addition to the obvious causes of cystitis, the possibility of renal tuberculosis should be considered and further systematic examination is necessary. (A) History analysis and physical examination: The presence of renal tuberculosis lesions should be considered for long-term chronic urinary frequency, urgency, painful urination and hematuria, or cystitis that does not heal with general anti-inflammatory treatment. In particular, urinary tract infections in young and middle-aged men with no general bacterial growth in urine culture should be examined for urological tuberculosis. During the physical examination, attention should be paid to TB lesions throughout the body, especially in the male genital tract to check for nodules in the prostate, vas deferens, and epididymis. The urinary tract should be examined for masses in the kidney area and percussion pain in the cribriform angle. (B) Laboratory tests: 1. Routine urine examination The urine is often acidic, contains a small amount of protein, and a small or moderate amount of red blood cells and white blood cells can be seen under the microscope in most patients. However, in the case of mixed urinary tract infection, the urine may be alkaline, and a large number of white blood cells or pus balls can be seen microscopically. 2, urinary common bacterial culture Kidney tuberculosis is a specific infection of the urinary tract. Urine culture of common bacteria should be negative. However, a significant proportion of patients with renal tuberculosis have mixed urinary tract infections, and urine culture of common bacteria can be positive. 3. Urine tuberculosis bacillus test (1) 24-hour urine antacid bacillus test Mycobacterium tuberculosis is one of the antacid bacilli. 24-hour urine is concentrated for direct smear antacid staining for antacid bacillus test. The method is simple, the result is rapid, and the positive rate can reach 50-70%. However, the bacillus of foreskin and the bacillus of grass are also acid-resistant bacilli that often exist in urine, so the acid-resistant bacillus in urine is not equal to the bacillus of tuberculosis. However, repeatedly and repeatedly this test can find the same acid-resistant bacilli, and combined with the clinical history and characteristics of the reference, it still has some reference significance for the diagnosis of renal tuberculosis. (2) Urinary tuberculosis culture Urinary tuberculosis culture is decisive for the diagnosis of renal tuberculosis. A positive urine culture for tubercle bacilli can confirm the diagnosis of renal tuberculosis. However, the culture time is long, and it takes 1 to 2 months to get the result, and the positive rate can be as high as 90%. (3) Urinary tuberculosis animal inoculation The results of urinary tuberculosis animal inoculation are of high value for the diagnosis of renal tuberculosis and can be used as a basis for the diagnosis of renal tuberculosis, with a positive rate of more than 90%. However, it is time-consuming and takes up to 2 months to obtain the results. 4, urine tuberculosis IgG antibody determination Nassau et al. found a certain amount of specific antibodies in active tuberculosis patients, and Grauge et al. proved that the specific antibodies were IgG class. The First Affiliated Hospital of Hubei Medical College reported that the enzyme-linked immunosorbent assay was used to determine TB IgG antibodies in urine using polymeric OT as antigen, and the positive rate was up to 89.1% in the urine of patients with renal tuberculosis who had TB IgG antibodies. This test proved to be specific and sensitive, and has considerable clinical significance for the diagnosis of renal tuberculosis. However, in case of advanced renal tuberculosis and the kidney function is severely impaired and cannot secrete urine, or renal tuberculosis is complicated by ureteral obstruction, the urine on the diseased side cannot be discharged and the urine tested comes from the healthy kidney, false negative may occur. 5.Tuberculin test Tuberculin test is a test to check whether the human body is infected with Mycobacterium tuberculosis, most often used in pulmonary tuberculosis, but also has reference value for tuberculosis lesions in other organs of the body. (1) Tuberculin has the following types: ① old tuberculin; ② pure tuberculin; ③ pure protein derivatives made from atypical mycobacteria; ④ kaja mycobacteria. (2) test method: using the old tuberculin standardized solution, the first time with 1/1000 or 1/2000 (each 0.1ml containing 10.5TU) dilution 0.1ml injected into the left forearm in the middle 1/3 of the skin. 48 to 72 hours later to observe the reaction, such as negative, and then 1/100 (each 0.1ml containing 100TU) dilution to repeat the test and determine the reaction results The results of the reaction will be determined. Treatment measures Renal tuberculosis is secondary to systemic tuberculosis, so in the treatment must pay attention to systemic treatment and combined with local lesions in a comprehensive consideration, in order to receive more satisfactory results. (a) Systemic treatment: Systemic treatment includes appropriate rest and medical sports activities as well as adequate nutrition and necessary medication (including treatment of other TB lesions in the body other than renal TB). (ii) Drug therapy: Because the extent of localized lesions and the degree of destruction of renal tuberculosis vary greatly, the treatment of localized lesions varies from case to case. Before the discovery of antituberculosis drugs such as streptomycin, once the diagnosis of renal tuberculosis was established, the only treatment was nephrectomy. After the 1940s, streptomycin and para-aminolevulinic acid were introduced one after another, and many clinical cases of renal tuberculosis could be cured by drug treatment alone. after the 1950s, the highly effective, low-toxic and inexpensive isoniazid became available, and the combination of drugs was adopted, so that the efficacy of renal tuberculosis was greatly improved, and almost all early tuberculosis lesions could be cured. In 1966, rifampicin was used clinically, and its effectiveness was improved by using it together with other drugs because of its significant effect and few side effects. The number of cases requiring nephrectomy for renal tuberculosis has been greatly reduced. However, in some areas with poor sanitation and inadequate medical care, renal tuberculosis still occurs and is even found in some patients with advanced disease. For patients diagnosed with renal tuberculosis, anti-tuberculosis drugs must be administered according to a certain regimen, regardless of the extent of the lesion and whether or not surgery is required.