Genitourinary tuberculosis

Abstract

The worldwide prevalence of tuberculosis is still high and has remained almost unchanged over the past century as a result of increasing incidence in countries of the Third World. Twenty per cent of patients with tuberculosis will develop an extrapulmonary manifestation over time, the most common site being the genitourinary tract. The patient's history can lead to the sometimes difficult diagnosis. Radiological imaging helps in depicting genitourinary tuberculosis. However, the diagnosis of genitourinary tuberculosis is made on the basis of culture studies and is supported by polymerase chain reaction. The latter has impressive sensitivity and specificity, but lacks the ability to determine biological activity. The combination of three or four anti-tuberculosis drugs over a course of 6 to 9 months remains the treatment of choice. Drug resistance is increasing and necessitates tight therapy control. Tuberculosis of the male seminal duct may be an important cause of male infertility as a result of multiple epididymidal scarring. In these cases testicular sperm extraction is the method of choice for sperm retrieval. The outcome of sperm retrieval followed by intracytoplasmatic sperm injection is not affected.

Prostatic tuberculosis: case report

“…Intravenous urographic examination is recommended because, in a high percentage of cases, renal tuberculosis is found in association. 2,3 In our case, CT scans showed an abscess with central necrosis that improved after treatment. These characteristics may be considered diagnostic for tuberculosis.…”

“…2,3 Today, extrapulmonary tuberculosis is becoming increasingly common, especially involving the lymphatic system, pleura and urogenital tract. 3 Extrapulmonary sites are involved in 50% to 70% of immunocompromised patients, especially HIV patients. Genitourinary tuberculosis accounts for 5-10% of extrapulmonary cases in developed countries and 15-20% in developing countries.…”

Review of genitourinary tuberculosis with focus on end-stage renal disease

“…It is important to be aware that a high proportion of men with genital tuberculosis (50 -75%) have radiologic abnormalities in the urinary tract, which did not happen in this case once the ultrasonography of the genital region was normal. The urinary tract of such patients with primary location of tuberculous infection on the epididymis should be investigated 13 .…”

“…One has to be aware that the latency between pulmonary manifestation and genitourinary TB is enormous. In some cases, it could take more than 30 years before genitourinary TB becomes evident 13 . …”

Genitourinary tuberculosis in a 54-year-old woman: diagnostic difficulty

“…The kidney is usually the first organ of the urinary tract to be infected, with other parts infected by direct extension [7]. Development of disease depends on the interaction between the pathogen and the host immune system, which may take up to 20 years from the primary infection [2,8,9]. Initial infection occurs at the renal cortex, where the bacillus lodges and forms granulomas.…”