REVIEW ARTICLES Genitourinary tuberculosis: historical and basic science review: past and present

Abstract

Genitourinary tuberculosis (GUTB) usually results from the reactivation of old, dormant tuberculous diseases by pathogens of the mycobacterium tuberculosis complex. GUTB is the second most common form of extrapulmonary tuberculosis, with more than 90% of cases occurring in developing countries. In GUTB, the kidneys are the most common sites of infection and are infected through hematogenous spread of the bacilli, which then spread through the renal and urinary tract. Patients with genital and urethral TB present with a superficial tuberculous ulcer on the penis or in the female genital tract develop mainly due to primary contact with mycobacterium exposure during intercourse or inoculation via goods or chattels contaminated with mycobacterium.The diagnosis of TB of the urinary tract is based on the case history, the finding of pyuria in the absence of infection as judged by culture on routine media, and by radiological imaging. However, a positive yellow egg culture and/or histological analysis of biopsy specimens, possibly combined with the polymerase chain reaction (PCR), is still required in most patients to establish a definitive diagnosis of GUTB.The standard antituberculous drug treatment should be administered initially for two months during the intensive phase with three or four drugs daily followed by dual continuation therapy for four months. Surgery as a treatment option in GUTB might be indicated in complicated urinary tuberculosis. After antituberculous treatment of GUTB, surveillance with regular follow-up visits over the next five years is recommended.In cases of drug resistance, additional drugs and prolonged treatment are required. Furthermore, increasing rates of drug-resistant cases and co-infection with HIV pose challenges in the treatment GUTB and other forms of TB.

Female genital tuberculosis: a clinicopathological study

“…Tuberculosis is found in one third of the HIV infected individuals. 2 In India tuberculosis is the leading cause of mortality. Every ninety seconds one person dies due to tuberculosis.…”

A case of testicular tuberculosis mimicking malignancy in a healthy young man

“…Risk factors of GUTB include previous history of TB infection, immunocompromised conditions, immigration or travel to endemic areas, immunosuppressive therapy, and prolonged use of steroids [Hadadi et al 2012]. Sexual transmission has also been noted in some cases [Zajaczkowski, 2011]. For the patient discussed in this report, his native country of Ecuador has a high incidence rate of TB infections of 54 per 100,000 individuals (compared with 3.1/100,000 in the United States) [WHO, 2015].…”

Renal tuberculosis

“…Parcijalna nefrektomija može da bude primenjena u slučajevima kada je lezija lokalizovana polarno na bubregu, a izostao je odgovor na medikamentoznu terapiju i nakon 6 nedelja primene, ili kada se polje kalcifikacije obolelog dela bubrega postepeno uvećava i preti da zahvati ceo bubreg (3).…”