Tuberculosis of the genitourinary system (urogenital tuberculosis) is a rare disease, and its symptoms are not very characteristic: low-grade fever or fever, general weakness. Only with time, urinary system ailments may appear, such as frequent and painful urination, hematuria or pain in the lumbar region of the spine. First of all, people over 45 years of age are ill, and cases of the disease in children belong to casuistry.

Genitourinary tuberculosis( urogenital tuberculosis ) is a reactivation of the primary tuberculosis site in the lungs. Usually, urogenital symptoms appear 20 years after infection. The organs that are usually affected by Mycobacterium tuberculosis include the kidneys, ureters, bladder, urethra and genitals. In the latter case, direct infection from the host through sexual contact is possible, but in most cases tuberculosis is secondary infection.

The development of tuberculosis consists in the transmission of the pathogen (in this case it is mycobacterium tuberculosis) from the primary focus, which are the lungs, to the secondary location, which is the kidneys. The mycobacteria move from the cortex to the renal core through the blood and lymphatic vessels. This is followed by necrosis and disintegration of the focus, which causes the spread of bacteria to other structures of the genitourinary system.

Urogenital tuberculosis: symptoms

Symptoms that the bacteria have entered the genitourinary system are not very characteristic, which makes it difficult to diagnose and implement pharmacological treatment. The disease is secretive, and the first signs of infection may appear even 20 years after the initial infection. Most often, patients report:

  • general weakness for no apparent reason
  • sweating, especially at night
  • low-grade fever and fever

After a while, new symptoms appear depending on the organ involved. They can be:

  • discomfort in the lumbar region of the spine, in the projection of the kidneys
  • dysuria symptoms, i.e. symptoms that accompany urinating
  • micturition disorders, frequent urination or, on the contrary, very rare
  • in the case of involvement of the male genital organs, e.g. epididymiscomplain not only of local symptoms in the form of pain, but also of chronic inflammatory changes in the form of lumps and scars
  • in women, involvement of the reproductive organ is manifested by menstrual disorders (rare and scanty periods), intra-uterine adhesions and primary infertility

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Diagnosis of urogenital tuberculosis

The diagnosis of tuberculosis requires, first of all, bacteriological diagnostics aimed at identifying the presence of mycobacteria. Laboratory tests show pyuria, sometimes hematuria. A history of pulmonary tuberculosis, HIV, or other immunocompromising conditions should raise the suspicion of the disease. An important diagnostic element is the removal of the changed tissue and the evaluation of the preparation in a microscopic examination. It is very important not to take samples from places that may be affected by neoplasia, i.e. the process of cancer. A good example is the opening of the ureters. In addition, mycobacteria of tuberculosis should be searched for in the urine. It is cultured 3-6 times on consecutive days from the morning urine.

When the basic examination panel turns out to be insufficient, diagnostic imaging tests are performed: urography, cystoscopy, and in some cases computed tomography. On the other hand, ultrasound is a perfect tool for monitoring the dynamics of changes during pharmacotherapy.

Treatment of genitourinary tuberculosis

Treatment of genitourinary tuberculosis does not differ much from that practiced in classical pulmonary tuberculosis. The therapeutic effects are very good. The reason is, among others good blood supply to the kidneys, which improves the penetration of drugs into the renal parenchyma. Treatment of tuberculosis usually lasts from about 6-12 months. Unfortunately, drugs used as part of antituberculosis therapy, on the one hand, very effectively destroy small foci of tuberculosis, but on the other hand, they have a number of side effects, many of which affect the kidneys. They can cause kidney tissue fibrosis in a later stage, even kidney failure. The first alarm signal is urinary retention. In addition to pharmacotherapy, surgical treatment is still used, including ablation procedures practiced, for example, in the case of abscesses. The removal of the inactive kidney remains a controversial issue in the event of only limited tuberculosis foci.

Category:

Infectious diseases