Urogenital tuberculosis. A 10-year experience

Objective: To review the clinical, imaging and therapeutic aspects of uroge nital tuberculosis. Material and Methods: From April 1989 to April 1999, 57 patients with uroge nital tuberculosis were reviewed in our department. This series consisted o f 32 males and 25 females with a mean age of 40 years (range: 18 to 72 year s). 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 creat inine: 18 mg/l). Only 3 cases (5.2%) presented with bacilluria. Urography s howed abnormalities in 80% of cases. The most frequent abnormality was a no n-functioning silent kidney in 23 cases (40.3%). The positive diagnosis was based an bacteriological (5 cases) and histological data (52 cases). Treatment consisted of antituberculous chemotherapy in all patients, in com bination with surgery (75%), and/or endourological procedures (26.3%). Nephrectomy is still indicated for non-functioning tuberculous kidneys in o rder to prevent the development of hypertension. abscess and fistulas. Conclusion: The diagnosis of urogenital tuberculosis is difficult and often lure. A surgical or endourological procedure is often necessary to preserv e renal function and to improve quality of life.