Current Status of Genitourinary Tuberculosis: Presentation, Diagnostic Approach and Management-Single Centre Experience at IGIMS (Ptana, Bihar, India)

Abstract

Genitourinary tuberculosis (GUTB) is associated with significant morbidity and mortality. As patients with GUTB have no specific symptoms or clinical features, early diagnosis and treatment of GUTB is clinically challenging. The present study assessed the current spectrum of clinical presentation, urinary findings and radiological signs of patients with GUTB. Patients with confirmed GUTB (n = 53) were analysed for clinical presentation, diagnostic tests and management. Data about demographic details, clinical presentation, urine routine examination, urine acid-fast bacillus (AFB) smear test, urine Mycobacterium tuberculosis culture, routine blood investigations, radiological, cystoscopic and histopathological examinations were recorded for all study patients. Various surgical interventions were performed on the basis of the site involved. After surgical procedure, patients were treated with chemotherapy and followed up for one year to till date. The present study patients were from the age range of 19–75 years with female preponderance. The most common clinical presentation was irritative voiding symptoms (69.81%), haematuria and flank pain (56.60%, each). The most commonly affected organ was kidney (62.26%) following ureter (30.19%), urinary bladder (24.53%), prostate (9.43%) and epididymis (1.89%). The urine AFB smear and urine culture for M. tuberculosis tests were positive in 13.18% and 54.71% of patients, respectively. Surgical interventions were done in majority (75.47%) of patients. Accurate and early diagnosis is vital for the better management of patients with GUTB. Apart from the available course of chemotherapy, surgical intervention is also required for complete management.