Urogenital tuberculosis

Urogenital tuberculosis
Synonyms	Genitourinary tuberculosis
Pronounce	N/A
Specialty	N/A
Symptoms	Dysuria, hematuria, flank pain, fever, weight loss
Complications	Kidney failure, infertility, ureteral stricture
Onset	Variable, often months to years after initial infection
Duration	Chronic
Types	N/A
Causes	Mycobacterium tuberculosis infection
Risks	HIV/AIDS, immunosuppression, diabetes mellitus
Diagnosis	Urine culture, imaging studies, tuberculin skin test, interferon-gamma release assays
Differential diagnosis	Urinary tract infection, renal cell carcinoma, interstitial cystitis
Prevention	N/A
Treatment	Antitubercular therapy (e.g., isoniazid, rifampicin, ethambutol, pyrazinamide)
Medication	Antibiotics
Prognosis	N/A
Frequency	Rare in developed countries, more common in regions with high tuberculosis prevalence
Deaths	Rare with treatment, but can be fatal if untreated

Urogenital tuberculosis is a form of tuberculosis that affects the urinary system and the genital organs. It is a type of extrapulmonary tuberculosis, which means it occurs outside the lungs. This condition is caused by the bacterium Mycobacterium tuberculosis, the same organism responsible for pulmonary tuberculosis.

Pathophysiology

Urogenital tuberculosis typically begins as a hematogenous spread from a primary infection site, often the lungs. The bacteria can lodge in the kidneys, which are the most common site of infection in the urogenital tract. From the kidneys, the infection can spread to the ureters, bladder, and urethra. In men, it can also affect the prostate gland, seminal vesicles, and epididymis. In women, the fallopian tubes and endometrium may be involved.

Symptoms

The symptoms of urogenital tuberculosis can vary depending on the organs involved. Common symptoms include:

• Dysuria (painful urination)
• Hematuria (blood in urine)
• Flank pain
• Fever and night sweats
• Weight loss
• Infertility in both men and women

Diagnosis

Diagnosis of urogenital tuberculosis can be challenging due to its nonspecific symptoms. It often requires a combination of:

• Urine culture for Mycobacterium tuberculosis
• Polymerase chain reaction (PCR) tests
• Imaging studies such as ultrasound or CT scan
• Cystoscopy and biopsy

Treatment

The treatment of urogenital tuberculosis involves a prolonged course of antitubercular therapy (ATT), which typically includes a combination of drugs such as isoniazid, rifampicin, ethambutol, and pyrazinamide. The duration of treatment is usually 6 to 9 months, but it may be extended in complicated cases.

Prognosis

With appropriate treatment, the prognosis for urogenital tuberculosis is generally good. However, delayed diagnosis and treatment can lead to complications such as renal failure, ureteral strictures, and infertility.

Related pages

• Tuberculosis
• Extrapulmonary tuberculosis
• Urinary tract infection

References

• World Health Organization. (2021). "Tuberculosis Fact Sheet." Retrieved from [1]