el Khader K, Lrhorfi M H, el Fassi J, Tazi K, Hachimi M, Lakrissa A
Service d'Urologie B, Hôpital Avicenne, Rabat, Maroc.
Prog Urol. 2001 Feb;11(1):62-7.
To review the clinical, imaging and therapeutic aspects of urogenital tuberculosis.
From April 1989 to April 1999, 57 patients with urogenital tuberculosis were reviewed in our department. This series consisted of 32 males and 25 females with a mean age of 40 years (range: 18 to 72 years).
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 creatinine: 18 mg/l). Only 3 cases (5.2%) presented with bacilluria. Urography showed abnormalities in 80% of cases. The most frequent abnormality was a non-functioning silent kidney in 23 cases (40.3%). The positive diagnosis was based on bacteriological (5 cases) and histological data (52 cases). Treatment consisted of antituberculous chemotherapy in all patients, in combination with surgery (75%), and/or endourological procedures (26.3%). Nephrectomy is still indicated for non-functioning tuberculous kidneys in order to prevent the development of hypertension, abscess and fistulas.
The diagnosis of urogenital tuberculosis is difficult and often late. A surgical or endourological procedure is often necessary to preserve renal function and to improve quality of life.
