Clinical study and management of genitourinary tuberculosis

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dc.contributor.authorChandrasekhar, Immadien_US
dc.contributor.authorJose, asalapudi Anuragen_US
dc.date.accessioned2019-12-02T10:10:45Z
dc.date.available2019-12-02T10:10:45Z
dc.date.issued2019
dc.description.abstractBackground: Tuberculosis can affect any organ system of the body, including the genitourinary tract. Genitourinary TB is the most common form of extra pulmonary TB accounting for 27% (14- 41%) worldwide. Aim and objectives: To study distribution of GU TB in relation to age, sex, anatomical site, signs and symptoms and to study various diagnostic modalities, treatment and role of surgery in GU TB. Materials and methods: This study was a cross sectional study done at department of Urology, King George hospital, Visakhapatnam. The study was done over a period of 30 months, which was from September 2014 to February 2017. All the patients reporting to the hospital with proven genitourinary tuberculosis or diagnosed after coming to the hospital were included in the study. Total number of cases was 35. 10 were males and 25 were females. History, physical examination, laboratory and radiological investigations were done on the patients and the primary focus of the disease and organs involved are determined. All the patients received treatment as indicated. Results: Most of the patients (33 out of 35) belonged to low socio-economic status and came from rural settings. Of them 10(28.57%) were males and 25(71.43%) were females. The mean age of patients was 36 years (range 16-60years). 2 patients were <20 years, 11 patients were between 21-30 years, 11 patients were between 31-40 years, 8 patients were between 41-50 years and 3 were above 50 years. In this study, kidney was involved in 19 cases and was the most common organ involved, followed by bladder (14 cases) and ureter(10 cases). Irritative voiding symptoms were the most common symptom seen in 23 cases. Flank pain was noted in 20 cases, sterile pyuria in 22 cases and hematuria in 7 cases. Six(17.14%) out of thirty five patients had renal failure at the time of presentation and diagnosis. Nephrectomy was done in 12 cases. Nephrectomy with augmentation Immadi Chandrasekhar, Pasalapudi Anurag Jose. Clinical study and management of genitourinary tuberculosis. IAIM, 2019; 6(1): 48-57. Page 49 cystoplasty and ureteric reimplantation was done in another 6 cases. Ileal conduit was done in 6 cases. Ureteric reimplantation with psoas hitch was done in 3 cases. Conclusion: Genitourinary tuberculosis is often silent and has nonspecific clinical features. Irritative voiding symptoms are the common presentation. Kidney is the most commonly affected organ in GU TB. GU TB is a disease of young adults, with majority affected in the 3rd and 4th decades. CT scan is replacing IVU as an imaging modality of choice in GU TB. Diagnosis of GU TB can be baffling, compelling a high index of suspicion owing to paucibacillary load in the biological specimens and the difficulty to isolate or grow TB bacilli. Hence a strong clinical suspicion is necessary for correct diagnosis. Anti-tubercular therapy is the mainstay of treatment. Genitourinary tuberculosis results in sequel which may require major organ removing and reconstructive surgeriesen_US
dc.identifier.affiliationsAssistant Professor, Department of Urology, Andhra Medical College, Visakhapatnam, Andhra Pradesh, Indiaen_US
dc.identifier.affiliationsConsultant Urologist, GITAM Institute of Medical Sciences and Research (GIMSR), Visakhapatnam, Andhra Pradesh, India, dranuragjose5@gmail.comen_US
dc.identifier.citationChandrasekhar Immadi, Jose asalapudi Anurag . Clinical study and management of genitourinary tuberculosis. International Archives of Integrated Medicine. 2019 Jan; 6(1): 70-75en_US
dc.identifier.issn2394-0026
dc.identifier.issn2394-0034
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/187220
dc.languageenen_US
dc.publisherEducational Society for Excellenceen_US
dc.relation.issuenumber1en_US
dc.relation.volume6en_US
dc.subjectCystoscopyen_US
dc.subjectDMSA (dimercaptosuccinic acid) scanen_US
dc.subjectIleal conduiten_US
dc.subjectMantoux testen_US
dc.subjectMycobacterium tuberculosisen_US
dc.subjectNephrectomyen_US
dc.subjectRenogramen_US
dc.subjectUreteric reimplantationen_US
dc.titleClinical study and management of genitourinary tuberculosisen_US
dc.typeJournal Articleen_US
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