PROFILE OF GENITOURINARY TUBERCULOSIS OVER A PERIOD OF 5 YEARS – A SINGLE INSTITUTIONAL STUDY.

DR SURYA KANT CHOUBEY; DR GOTAM PIPARA; DR SAURABH MITTAL

Volume : VII, Issue : XII, December - 2017

PROFILE OF GENITOURINARY TUBERCULOSIS OVER A PERIOD OF 5 YEARS – A SINGLE INSTITUTIONAL STUDY.

Dr Surya Kant Choubey, Dr Gotam Pipara, Dr Saurabh Mittal

Abstract :

BACKGROUND AND AIM– Tuberculosis (TB) is the commonest worldwide cause of mortality from infectious diseases ¹with nine million new cases and two million fatalities per year². There has been a paucity of data on genitourinary tuberculosis and its profile. Genitourinary tuberculosis is the most common extra pulmonary site that can cause obstruction, strictures and destruction of the renal unit.

METHODS – 252 patients presented to the Department of Urology at St Johns medical college and hospital, Bangalore, Karnataka between July 2011 and August 2016 and were studied in a prospective manner. Detailed history, clinical examination, urine examination and culture, AFB smear and culture, imaging studies, PCR and cystoscopy and biopsy whenever needed were done and noted for all the patients

RESULTS– Urine AFB was positive in 89%, most common presenting symptom was frequency – urgency –82 % and the most common radiological finding was hydroureteronephrosis accounting to 20.63 %. All these patients were stented. Nonfunctional kidney was noted in 8 patients for whom a nephrectomy was done, bladder augmentation was done in 4 patients, ureteroureterostomy and Boari flap in 2 patients for ureteric strictures. All surgical interventions were done after minimum 4 weeks of ATT. Almost all patients had symptom relief by 6 months of ATT.

CONCLUSION– Renal tuberculosis is a disease that must be kept in mind when a patient comes to us with unrelieved symptoms even after treatment or nonspecific symptoms especially with a background of tuberculosis in the past or family history of tuberculosis. The disease has a wide spectrum of presentation ranging from loin pain to nonfunctional kidneys. With early institution of therapy, both the cost and duration of treatment can be minimized.