Penile Tuberculosis After Intravesical Bacille Calmette-Guérin Immunotherapy

Linden-Castro, E.; Pelayo-Nieto, M.; Alías-Melgar, Alejandro

doi:10.1016/j.urology.2014.04.037

Cited by 9 publications

(4 citation statements)

References 7 publications

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“…Although few studies report better side effect profile of one strain over the other but these results may be biased by the differences in dose and schedule used and the choice of strain for instillation mostly depends on its availability rather than possibility of local complications (58,59). After instillation into the bladder, reflux of the contaminated urine into the epididymis and prostate results in this granulomatous inflammation, whereas the penile lesions usually develop after an incidence of local trauma along with spillage (60,61). Clinical presentation is similar to that of infections caused by Mycobacterial tuberculosis and can only be differentiated on tubercular culture and should be suspected if there is a recent history of vaccine instillation (58).…”

Section: Intravesicle Bcg Therapy and Genital Tuberculosismentioning

confidence: 99%

Genital tuberculosis: current status of diagnosis and management

Yadav

Singh

Hemal

et al. 2017

Transl. Androl. Urol.

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Genitourinary Tuberculosis (GUTB) is the second most common extra-pulmonary manifestation of tuberculosis (Tb) and an isolated involvement of genital organs is reported in 5–30% of the cases. Genital involvement results from primary reactivation of latent bacilli either in the epididymis or the prostate or by secondary spread from the already infected urinary organs. The epididymis are the commonest involved organs affected primarily by a hematogenous mode of spread. Tb is characterized by extensive destruction and fibrosis, thus an early diagnosis may prevent function and organ loss. The gold standard for diagnosis is the isolation and culture of mycobacterium tuberculosis bacilli and in the cases of suspected GUTB, it is commonly looked for in the urinary samples. All body fluid specimens from possible sites of infection and aspirates from nodules must also be subjected to examination. Radiologic investigations including ultrasonography and contrast imaging may provide supportive evidence. Anti-tubercular chemotherapy is the first line of management for all forms of genital Tb and a 6 months course is the standard of care. Most patients with tubercular epididymo-orchitis respond to antitubercular therapy but may require open or percutaneous drainage. Infertility resulting from the tubercular affliction of the genitalia is multifactorial in origin and may persist even after successful chemotherapy. Multiple organ involvement with obstruction at several sites is characteristic and most of these cases are not amenable to surgical reconstruction. Thus, assisted reproduction is usually required. Post treatment, regular annual follow up is recommended even though, with the current multi drug therapy, the chances of relapse are low.

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Section: Intravesicle Bcg Therapy and Genital Tuberculosismentioning

confidence: 99%

Genital tuberculosis: current status of diagnosis and management

Yadav

Singh

Hemal

et al. 2017

Transl. Androl. Urol.

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“…TB of the penis is considered as a sexually transmitted disease [12][13][14]. TB of the penis may occur as a complication of Bacillus Calmette-Guérin (BCG)-therapy for bladder cancer [15,16].…”

Section: Male Genital Tuberculosis Is Sub-divided Into Five Categorie...mentioning

confidence: 99%

The therapy for urogenital tuberculosis

KULCHAVENYA,

ÇEK

2023

Marmara Medical Journal

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Tuberculosis (TB) is a communicable disease that is a major cause of ill health. Urogenital TB was a frequent urological disease in the pre-antibiotic era: about 20% of patients in urological hospitals had renal TB, mostly in the form of pyonephrosis. We composed a narrative review of the literature with keywords “urogenital tuberculosis’, “prostate tuberculosis” “kidney tuberculosis”, “treatment of tuberculosis”. Urogenital TB (UGTB) includes TB of the kidney and the urinary tract and male and female genital TB. Each clinical presentation requires tailored antibiotic therapy depending on stage and general management. Anti-TB therapy should be multicomponent, continuous, long-lasting and controlled with a follow-up for 2-3 years. Otherwise, the risks of development of drug-resistance and relapse increase. Index of suspicion on UGTB is generally low, causing a delay in diagnosis; consequently, complicated forms of UGTB respond poorly to anti-TB therapy, while timely diagnosed “minor” forms are curable medically without surgery. Even with timely diagnosed UGTB, non-optimal therapy may result in over-fibrosis, scarring and strictures of the urinary tract, making surgical repair inevitable. Nevertheless, we have a wide enough spectrum of anti-TB drugs to cure urogenital TB.

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“…The local inoculation of the BCG is the main causal factor due to improper execution of the procedure (oftentimes citing trauma, spillage, or difficult catheterization) . Inadvertent voidance of the instilled bladder content on the surrounding skin has also been implicated …”

Section: Histological Findings In Published Cases Of Immunotherapy‐rementioning

confidence: 99%