Genitourinary tuberculosis

From greek.doctor

Genitourinary tuberculosis refers to tuberculosis which has spread to urinary tract. Genitourinary TB is the second most common extrapulmonary manifestation of TB after lymph node. The bacteria spreads haematogenously to kidney -> bacteria descend. It's very rare.

  • A potential very rare complication of intravesical BCG
  • Genitourinary TB presents 5 – 25 years after initial infection
  • Clinical features
    • Dysuria
    • Flank pain
    • Haematuria
    • Pyuria
    • Low-grade fever
    • Gender-specific
      • Male – prostatitis
      • Female – amenorrhoea, discharge
  • Diagnosis
    • Apparent sterile pyuria
      • Pyuria with negative bacterial culture
      • PCR or special culture will show TB
    • Imaging: calcifications, strictures, parenchymal destruction
  • Treatment
    • Normal TB therapy
    • Surgery to remove adhesions, strictures
  • Complications
    • Ureteropelvic junction obstruction
    • Bladder fibrosis
    • Ureteral stricture
    • Adhesions of fallopian tube
      • Can cause infertility