Urinary Tuberculosis: Ten Years' Experience

Abstract

In this study of 26 patients, clinical features diagnosed as urinary tuberculosis in our nephrology and urology clinics between 1993 and 2002 were investigated retrospectively. Fifteen patients (52%) were male, and mean age was 43.5 (18-71). Twenty percent of the patients were asymptomatic. Frequency-dysuria (46%), flank pain (33%), and macroscopic hematuria (12%) were presenting symptoms. Physical examination was not diagnostically helpful in most patients. Hematuria and/or pyuria were detected in 80% of the patients. Eleven patients had positive urine cultures of Mycobacterium tuberculosis (42%), and 7 patients had positive smears (25%). Definitive diagnosis of urinary tuberculosis was established microbiologically in 15 patients (58%) and histopathologically in 11 patients (42%). Tuberculin skin test was positive in 60% of the patients. Eight patients had an abnormal chest roentgenogram. Hydronephrosis (majority bilateral) in 11 patients (42%), contracted bladder in 9 patients (34.6%), and renal calcification in 6 patients (23%) were detected. Two patients also had genital tuberculosis (epididymoorchitis). Although only medical treatment was applied in 13 patients for 9 months, in the rest of the patients medical therapy plus surgical intervention was carried out. End-stage renal failure developed in one patient who died on hemodialysis. Renal functions had decreased moderately in two other patients. In conclusion, the diagnosis of urinary tuberculosis was able to be established after the obstructive complications and functional losses were developed in a fair number of cases. Surgical treatment was carried out in half the patients. Urinary tuberculosis should be taken into consideration because early diagnosis and treatment is very important for the presenting of irreversible sequelae.

Genitourinary tuberculosis masquerading as a ureteral calculus

“…6 The physical exam is usually unremarkable since signs typically develop later in the disease process. 7 The diagnosis of GU TB should be considered with the findings of an abnormal urinalysis showing sterile pyuria and/or hematuria, which are present in more than 90% of patients.…”

Lúpus eritematoso sistêmico e tuberculose renal: descrição de nove Casos

“…Por outro lado, deve-se considerar ainda a dificuldade em distinguir os sinais de TB renal de uma possível nefrite lúpica. Em um estudo de 26 pacientes com TB renal realizado na Turquia, publicado em 2005 (10) , as manifestações de sedimento urinário foram hematúria e/ou leucocitúria, presentes em 87% dos casos. As manifestações clínicas, como lombalgia, disúria, dor suprapúbica, estavam presentes em apenas uma parcela dos pacientes, e a manifestação mais freqüente (disúria) ocorria em apenas 46% dos casos.…”

Quilúria

“…É possível, contudo, que o parênquima seja difusamente calcificado 21 . Uma vez que na tuberculose urinária possa, com freqüência, ocorrer tanto hematúria quanto piúria 22 , em pacientes que vivem em áreas endêmicas de bancroftose é preciso que se faça o diagnóstico diferencial com a quilúria. Em alguns casos, a urina pode não ter o aspecto leitoso clássico, possuir hemácias em seu sedimento e, erroneamente, ser referida à presença de piócitos e não de linfócitos.…”