In each case the primary treatment of tuberculosis is a medicamentous therapy. Using the modern basis medication of isoniazid, rifampicin, ethambutol and streptomycin at present for the normal case the short-term therapy of maximally 12 months made its way. The operative treatment of the urogenital tuberculosis is only a part of the total therapy plan. Among 715 patients nearly half of them had to undergo at least one surgical intervention from 1966 to 1983. The nephrectomy rate of 22.3% is to be classified as high and is conditioned by progressing and extended changes of the kidneys, which are in most cases recognized too late. In 69 patients partial resections of the kidney were performed. Since 1976 the indication for this intervention was in 13 cases made only intraoperatively and at the same this the planned nephropyeloplasty was performed on account of disturbance of the urine flow. Good postoperative results encourage to perform plastic reconstructive measures also in changes of the kidneys of stage III.