An update on lower urinary tract tuberculosis

Abstract

Tuberculosis of the genitourinary tract presents with atypical manifestations. Only 20% to 30% of patients with genitourinary tuberculosis have a history of pulmonary infection. Tuberculosis often affects the lower genitourinary system rather than the kidney. Tuberculosis of the lower genitourinary tract most commonly affects the epididymis and the testis, followed by bladder, ureter, prostate, and penis. Use of bacillus Calmette-Guérin therapy for bladder cancer can cause symptomatic tubercular infections of the lower genitourinary tract. Tuberculosis of the lower genitourinary tract can present with irritative voiding symptoms, hematuria, epididymo-orchitis, prostatitis, and fistulas. Tuberculosis of the seminal vesicles, vas, fallopian tubes, and the uterus can cause infertility. Urinalysis may demonstrate sterile pyuria, hematuria, or albuminuria. Identification of acid-fast bacilli in culture or tissue or by polymerase chain reaction studies is diagnostic. Medical treatment may not result in resolution of symptoms. Surgical intervention and reconstruction of the urinary tract are frequently indicated.

Tuberculosis of the genitourinary system-Urinary tract tuberculosis: Renal tuberculosis-Part I

“…UTB has an insidious onset, no specific symptoms and atypical presentations,[16] which lead to difficulty and delay in diagnosis. [19192021] Most patients present with local symptoms such as frequent voiding; dysuria;[21] pyuria;[17] back, flank, or abdominal pain;[222324] and microscopic or macroscopic hematuria.…”

“…[67] Only 20-30% of UTB patients will have a previous history of PTB; an additional 25-50% will have radiographic evidence of prior subclinical PTB. [1626]…”

“…[1415] Hence, HIV-positive patients should be tested for TB, and patients with newly diagnosed TB should be assessed for HIV infection. [16] In fact, with the improving survival rates of AIDS patients, we can expect an increase in the incidence of urinary tract TB. [6]…”

Isolated Testicular Tuberculosis in a 9-Year-Old Boy: An Incidental Finding

“…Genital TB occurs usually, through hematogenic spread to the epididymis and prostate or through the urinary system to the prostate and canalicular spread to the seminal vesicles, deferent ducts, and epididymis [9]. Testicular involvement is mostly due to local spread from the epididymis and rarely by haematogenous spread [10]. Cabral et al said that higher frequency of isolated lesions in children favoured the possibility of haematological spread of infection [11].…”

Prostatic Blastomycosis: An Infrequent Cause of Granulomatous Prostatitis

“…Clinical presentation may be similar to that of benign prostatic hypertrophy or it may even be clinically indistinguishable from that of prostate carcinoma [6], since it is frequently associated with an abnormal digital rectal examination [7], an elevated prostate-specific antigen (PSA) [8], or both. Infectious granulomatous prostatitis can be caused by Mycobacterium tuberculosis [9,10], BCG instillation for transitional cell carcinoma of the bladder [11,12], syphilis [13], malakoplakia [14], viruses [15], and various fungi [16].…”