A case of renal tuberculosis diagnosed during percutaneous nephrolithotomy

Percutaneous nephrolithotomy (PCNL) is very popular and an efficient method as a gold standard in management of renal calculi. It is the first-choice method in management of renal calculi larger than 2 cm. Our patient underwent PCNL upon observing multiple renal calculi larger than 10 mm in a lower pole of the right kidney. Biopsy was performed during PNCL because morphology and endoscopic view of the calyx were irregular, calcific and pale white in color. The patient developed prolonged urinary leakage from the lumbar region and J-stent was inserted after the re-entry catheter had been removed following successful PCNL. Prolonged urinary leakage persisted although location of the J-stent was normal. Tuberculosis of the urinary tract should be the first option in the differential diagnosis of fistula discharge following PCNL. In our patient, the biopsy taken at the time of PCNL revealed renal tuberculosis. Urinary tract tuberculosis must definitely be considered in the fistula tract persisted and not closed following PCNL as in the present case. Diagnosis of tuberculosis was made early in this case owing to tissue sampling during operation, and thus the treatment was begun early. So we consider this patient as a special case.