Vol. 5, Issue 10 (2019)
A study on etiology, clinical presentation and management of genitourinary tuberculosis: A prospective study
Author(s): Vidya Sagar S, Kiran Kumar G, Ram Reddy Ch, Ramachandraiah G
Abstract: Background: Genitourinary tuberculosis (GUTB) is the second most common form of extrapulmonary tuberculosis, with more than 90% of cases occurring in developing countries. In GUTB, the kidneys are the most common sites of infection and are infected through hematogenous spread of the bacilli, which then spread through the renal and genital tract. Aim & Objectives: The main aim of the present study is to identify the etiology, clinical presentation and management of genitourinary tuberculosis. Methodology: This is a prospective study of patients with a diagnosis of genitourinary tuberculosis who underwent treatment in Nizam's institute of medical sciences between September 2016 to December 2017. 60 patients with a diagnosis of genitourinary tuberculosis who underwent treatment were taken initially into the study. Results: During this 18 months period, 60 cases of genitourinary tuberculosis were identified. The study included 19 males (70.37%) and 8 females (29.62%) with a M: F ratio of 2.3:1. The mean age of the patients was 33.74 years (range 17 to 54 years). The youngest patient in this study was 16 years old and the oldest patient was 56 years old. 2 patients were <20yr, 25 patients were between 21-30 yrs, 17 patients were between 31-40 yrs, 11 patients were between 41-50 yrs and 2 were above 50 yrs. Irritative voiding symptoms were the most common symptom seen in 38 cases (66.66%) followed by Flank pain in 19 cases (33.33%), hematuria in 14 cases (24.56%), recurrent UTI in 14 cases (24.56%), constitutional symptoms in 17 cases (29.82%), and scrotal mass in 4 cases (7.01%). In our study, Raised ESR was present in 36 patients (63.15%) followed by Sterile Pyuria in 35 cases (61.40%). Anemia was found in 25 cases (43.85%), raised serum creatinine in 20 cases (35.08%). Mantoux test was positive in 11 cases (19.29%) and Leukocytosis was present in 10 cases (17.54%). Overall surgical intervention was done in 49 patients. All patients received 4 to 8 weeks ATT before they were taken up for surgical intervention. Conclusion: The study concluded that, all patients were followed up regularly at 2 weeks, 3 months and 6 months after discharge, and every 6 months thereafter. Renal function improved in 16 patients, stabilized in 30 and worsened in 9 patients. Although the role of surgery in GUTB has decreased since the advent of anti-TB therapy, it can still have a role as an adjunct to drug treatment. Today, the challenges of GUTB and other forms of TB include increasing rates of drug-resistant cases and co-infection with HIV.