[Urogenital tuberculosis. Experience in 10 years]

Abstract

Objective: To review the clinical, imaging and therapeutic aspects of urogenital tuberculosis.

Material and methods: From April 1989 to April 1999, 57 patients with urogenital tuberculosis were reviewed in our department. This series consisted of 32 males and 25 females with a mean age of 40 years (range: 18 to 72 years).

Results: The most frequent clinical symptoms were irritative symptoms (47.3%). Fever, anorexia and weight loss were rare (11%). 16% of patients had an isolated genital lesion. 14% presented with renal failure (mean serum creatinine: 18 mg/l). Only 3 cases (5.2%) presented with bacilluria. Urography showed abnormalities in 80% of cases. The most frequent abnormality was a non-functioning silent kidney in 23 cases (40.3%). The positive diagnosis was based on bacteriological (5 cases) and histological data (52 cases). Treatment consisted of antituberculous chemotherapy in all patients, in combination with surgery (75%), and/or endourological procedures (26.3%). Nephrectomy is still indicated for non-functioning tuberculous kidneys in order to prevent the development of hypertension, abscess and fistulas.

Conclusion: The diagnosis of urogenital tuberculosis is difficult and often late. A surgical or endourological procedure is often necessary to preserve renal function and to improve quality of life.