A retrospective observational study of presentation, diagnosis, and management of patients with genitourinary tuberculosis in a tertiary care hospital of India

Abstract

Objectives: To study the clinical features, diagnostic methods, and management of genitourinary tuberculosis (GUTB). Methods: This retrospective study included 117 patients with GUTB admitted over a period of 10 years. The analysis of the patients was done in terms of presentation, organ involved, diagnostic methods, and management. The 6-month anti-tubercular treatment (ATT) was given to all patients, which included isoniazid, rifampicin, and ethambutol/pyrazinamide. Follow-up period was 1–10 years. Results: The mean age of the patients was 32.5 ± 6.4 years with a male: female ratio of 1:1.51. The majority of the patients presented with irritative voiding symptoms (66.47%) and hematuria (47.6%). The common infected organs were kidney (64.9%), ureter (27.35%), urinary bladder (17.09%), prostate (3.4%), and epididymis (5.19%). 25.6% of patients had positive chest X-ray, and 61.2% of the patients had positive Mantoux test. The diagnostic positivity rate for polymerase chain reaction, urine Mycobacterium tuberculosis culture test, and urine acid-fast bacilli test was 67.7%, 35.4%, and 21.6%, respectively. 71 (60.13%) of the patients needed surgical intervention. After medical therapy, the adverse reactions noted were abnormal liver function in four cases, pruritus in three cases, and skin eruption in one case. Among the total of 117 patients followed over a period of 1 year to 10 years, none recurred. Conclusion: In a retrospective study of 117 patients with GUTB, majority had bladder symptoms, 60.13% needed surgery, and all were treated with 6-month course of ATT regimen consisting of isoniazid, rifampicin, and ethambutol/pyrazinamide, with none showing recurrence during the period of 1–10 years of follow-up.

Keywords

• genitourinary
• hydronephrosis
• nephrectomy
• tuberculosis