[Investigation and management of genito-urinary tuberculosis]

Rev Med Interne. 2014 Dec;35(12):808-14. doi: 10.1016/j.revmed.2014.07.006. Epub 2014 Sep 17.
[Article in French]

Abstract

Genito-urinary tuberculosis is the fourth most common manifestation of the disease, but it is often underestimated by clinicians because of few and non-specific symptoms and insidious disease course. The most common urinary findings are multiple ureteral stenosis. The most common genital involvement is an epididymal nodule for men and a chronic salpingitis for women. The definite diagnosis of genito-urinary tuberculosis is obtained on the basis of culture studies. Due to the paucibacillary nature of the disease, especially of genital location in woman, a probable or presumptive diagnosis is frequently considered with several parameters including radiological imaging (abdominal CT-scan, pelvic ultrasound, pelvic MRI). Endoscopic and surgical procedures are frequently required to obtain specimens for histopathologic and bacteriological studies. Medical treatment is the method of choice, with a combination of four drugs, namely isoniazid, rifampicin, ethambutol and pyrazinamide, followed by a two-drug regimen, for a total of six month duration. Surgery might be indicated in complicated genito-urinary tuberculosis (decreased renal function, infertility, urologic complaints).

Keywords: Epididymal nodule; Genito-urinary tuberculosis; Infertility; Infertilité; Multiple ureteral stenosis; Mycobacterium tuberculosis; Nodule épididymaire; Sténoses urétérales étagées; Tuberculose urogénitale.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Antitubercular Agents / therapeutic use
  • Diagnostic Imaging
  • Drug Therapy, Combination
  • Humans
  • Tuberculosis, Urogenital / diagnosis*
  • Tuberculosis, Urogenital / drug therapy*
  • Urinalysis

Substances

  • Antitubercular Agents