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Reconstructive surgery for contracted bladder (bladder tuberculosis stage 4) was performed in 21 patients: women underwent cystectomy, and men underwent cystectomy and cystprostatectomy. The artificial bladder was formed using segment of the ileum by the Studer method with the implementation of ureteral-intestinal anastomosis by Nesbit or Wallace methods. Criteria for determining the bladder tuberculosis 4 stage, requiring the implementation of reconstructive surgery were as follows: bladder capacity of 100 ml or less (including general anesthesia); bladder volume--150 ml or less in the presence of vesicoureteral reflux. A good results were obtained in 17 (80.9%) patients. Results of 3 (14.2%) patients were regarded as satisfactory; one patient developed a stricture of ureterovaginal-reservoir anastomosis, which required re-anastomosis; 1 patient formed a stricture of membranous urethra, which recurred after optical urethrotomy and required the implementation of anastomotic urethroplasty; and 1 patient had difficulty urinating, requiring intermittent catheterization. Poor result was recorded in 1 (4.7%) patient who was diagnosed with chronic renal failure progression, despite the lack of evidence of retention of the urinary tract and vesicoureteral reflux in the presence of spontaneous urination, and satisfactory bladder capacity. This fact was attributable to the antiretroviral therapy for HIV infection.

Tuberculosis of the urinary bladder (UB) is registered in 10-45.6% patients with urogenital tuberculosis. It is a severe incapacitating complication of kidney tuberculosis which significantly lowers quality of life. The results of the standard therapy of 76 patients with tuberculous cystitis are analysed. UB tuberculosis is diagnosed more often in women, outcomes of their treatment are worse. Twenty six patients with UB tuberculosis at the stage of overactive bladder received polychemotherapy and adjuvant trospium. After 3 months urination frequency decreased 4.3 times, on the average; UB volume increased 4.7 times, on the average. Complications were not registered.

Follow-up outcomes of urogenital tuberculosis with involvement of the bladder are provided for patients of the Novosibirsk regional and city hospitals. The cure was achieved in 42.1% of patients, posttuberculous cystalgia (PTC) developed in 36.8% microcystitis in 21.1% of cases. Age-related hormonal insufficiency contributes to the onset of PTC. An original technique of laser thermopuncture is detailed.