Clinical spectrum and management of genito-urinary tuberculosis in a tertiary care centre-institutional experience -a prospective study

Author: 
Senthilvel Arumugam., Jayaganesh Rajasekaran and Karthikeyan Animoor Sellamuthu

Background: Tuberculosis had been declared by the World Health Organization (WHO) as ‘public health emergency’ in1993. Extra pulmonary tuberculosis (E.P.T.B.) comprises 20-25% total burden of the disease in which genitourinary tuberculosis (G.U.T.B.) is 4%. Timely diagnosis and treatment will prevent the sequelae of this disease.
Aims: To know the varied clinical presentations, diagnostic modalities and management of G.U.T.B.
Material and Methods: The study population comprised 46 patients who were diagnosed with GUTB admitted in our institute from august 2016 to march 2018. They were analysed for clinical presentation, diagnostic modalities and management.
Results: Young patients mainly in third decade of life were commonly affected with higher incidence in females. In our study, the most common presentation was irritative voiding symptoms (73.91%) followed by Flank pain (39.13%). Although it can affect the entire organ in genito-urinary system but, in the present study, kidney was the most affected organ (73.91%) following ureter (30.43%), urinary bladder (17.39%), prostate (2.17%) and epididymis (2.17%)... In this study, we had not encountered any case of testicular and penile tuberculosis. Among the different diagnostic modalities in this study, the diagnostic positivity rate was 41.6% for the urine AFB test, 55.4% for the urine M. tuberculosis culture test and 67.7% for PCR. Chest x-ray was positive in 25.6%. ESR was raised in 62.5% patients.
Conclusion: A high index of suspicion and a wide range of investigations may be required to achieve a complete diagnosis of genitourinary tuberculosis. Though short course chemotherapy with four-drug-regimen for six month-duration is the mainstay of treatment, surgical interventions were required in 58.69% of cases of this study.

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DOI: 
http://dx.doi.org/10.24327/ijcar.2018.11633.2020
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