Challenges in urogenital tuberculosis

World J Urol. 2020 Jan;38(1):89-94. doi: 10.1007/s00345-019-02767-x. Epub 2019 Apr 17.

Abstract

Purpose: For better understanding of urogenital tuberculosis (UGTB), its clinical spectrum and characteristic features need to be evaluated.

Materials and methods: One hundred and forty-two cases of UGTB patients were analyzed retrospectively. We considered age, gender, symptoms, and diagnostic procedures.

Results: The total of 142 patients were divided into group A (consisted of 93 patients with only urinary TB), group B (consisted of 13 male patients with generalized UGTB, including urinary TB and male genital TB (MGTB). Group C consisted of 36 patients with MGTB. Sixty patients in groups A and B 56.6% had kidney TB third-to-fourth stages, which are incurable for anti-TB therapy and require surgery. The urinary tract was involved in 48 patients (45.3%): 25 (23.6%) had ureteral TB and 23 (21.7%) had also bladder TB. The most common symptom for kidney TB was flank pain (69.8%) followed by dysuria (47.2%). Perineal pain and dysuria were most common symptoms for prostate TB and were found in 87.5% (14 patients) and 56.3% (9 patients), respectively. Of total, in only 58 UGTB patients (40.8%), the culture for Mycobacterium tuberculosis (Mtb) was positive.

Conclusion: Of 142 patients with UGTB, 106 (74.7%) had kidney TB and 13 (9.2%) of them had kidney TB in combination with MGTB. Only MGTB (prostate, scrotal, or generalized) was diagnosed in 49 (34.5%) patients. The most common symptoms were flank pain and dysuria. Identification of Mtb in UGTB is difficult. Therefore, the most advanced microbiological technology should be used to establish the correct diagnosis.

Keywords: Epidemiology of tuberculosis; Kidney tuberculosis; Male genital tuberculosis; Mycobacterium tuberculosis; Prostate tuberculosis; Urogenital infections; Urogenital tuberculosis.

MeSH terms

  • Adult
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Multidetector Computed Tomography / methods
  • Mycobacterium tuberculosis / isolation & purification*
  • Retrospective Studies
  • Russia / epidemiology
  • Tuberculosis, Urogenital / diagnosis*
  • Tuberculosis, Urogenital / epidemiology
  • Tuberculosis, Urogenital / microbiology
  • Urinary Tract / microbiology*
  • Young Adult