Genitourinary Tuberculosis

Genitourinary tuberculosis results from hematogenous spread and may manifest within 5 to 15 years of the primary infection.

Clinical Features Top

In the majority of patients, the disease presents with signs and symptoms of cystitis. Systemic manifestations are rare.

Diagnosis Top

Urinalysis reveals leukocyturia with negative culture results (sterile pyuria); proteinuria and occasionally hematuria develop later in the course of the disease. Imaging studies may reveal a deformed pyelocalyceal system, ureteral stenosis or obstruction, increased bladder wall thickness, and decreased bladder capacity. Confirming the diagnosis usually requires multiple cultures for Mycobacterium tuberculosis; less frequently, the diagnosis is based on histologic examination and cultures of tissue samples collected during endoscopic examination of the urinary tract.

Treatment Top

Administration of antituberculous drugs for 6 months (as in pulmonary tuberculosis) with dosage adjusted to the patient’s kidney function.