Department of Urogenital, Novosibirsk TB Research Institute, 81-a Okhotskaya Str., Novosibirsk, 630040, Russian Federation,
J Infect Chemother. 2013 Oct;19(5):880-3. doi: 10.1007/s10156-013-0586-9. Epub 2013 Mar 25.
Urogenital tuberculosis (UGTB) plays an important role because its complications may be fatal, it significantly reduces quality of life, and it is often associated with AIDS. Diagnosis of UGTB is often delayed. We analyzed 131 case histories of UGTB patients from the years 2009-2011. Gender, age, and the clinical form and main features of the disease were taken into account. The most common form was kidney tuberculosis (74.8%). Isolated kidney tuberculosis (KTB) more often occurs in women: 56.8%. Patients of middle and old age more often showed the stage of cavernous KTB; younger patients had smaller forms. Among all cases, an asymptomatic course was seen in 12.2% and, among cases of KTB, in 15.9%. Every third patient complained of flank pain and dysuria (35.2% and 39.8%, respectively); 17% presented with toxicity symptoms, 9.1% with renal colic, and 7.9% with gross hematuria. Mycobacterium tuberculosis (MTB) in urine was found in 31.8% of cases in all levels of isolated KTB. UGTB has no specific symptom; even sterile pyuria occurs only in 25%. The acute onset of tuberculous orchiepididymitis was seen in 35.7% of patients, hemospermia in 7.1%, and dysuria in 35.7%. The most common complaints for prostate tuberculosis were perineal pain (31.6%), dysuria (also 31.6%), and hemospermia (26.3%). MTB in prostate secretion/ejaculate was revealed in 10.5% of this group. All urogenital tract infections should be suspected as UGTB in patients who are living in a region with a high incidence rate, who have had contact with tuberculosis infection, and who have a recurrence of the disease that is resistant to standard therapy.
泌尿生殖系统结核（UGTB）起着重要的作用，因为它的并发症可能是致命的，它显著降低了生活质量，并且它通常与艾滋病有关。UGTB 的诊断经常被延迟。我们分析了 2009-2011 年期间 131 例 UGTB 患者的病史。考虑了性别、年龄以及疾病的临床形式和主要特征。最常见的形式是肾结核（74.8%）。孤立性肾结核（KTB）更常见于女性：56.8%。中老年患者更常出现空洞性 KTB 阶段；年轻患者则具有较小的形式。在所有病例中，无症状病程为 12.2%，而 KTB 病例中为 15.9%。每三个患者中就有一个抱怨腰痛和尿痛（分别为 35.2%和 39.8%）；17%出现毒性症状，9.1%出现肾绞痛，7.9%出现肉眼血尿。在所有孤立性 KTB 病例中，尿液中发现结核分枝杆菌（MTB）的比例为 31.8%。UGTB 没有特异性症状；即使无菌性脓尿也仅发生在 25%的病例中。急性结核性附睾炎睾丸炎的发生率为 35.7%，血精症为 7.1%，尿痛为 35.7%。前列腺结核最常见的症状是会阴疼痛（31.6%）、尿痛（同样为 31.6%）和血精症（26.3%）。前列腺分泌物/精液中 MTB 的检出率为 10.5%。在高发病率地区生活、接触过结核病感染、以及对标准治疗有抗药性的疾病复发的患者中，所有泌尿生殖道感染都应怀疑为 UGTB。
