Venyo Anthony Kodzo-Grey
Department of Urology, North Manchester General Hospital, Delaunay's Road, Manchester, UK.
Scientifica (Cairo). 2015;2015:601624. doi: 10.1155/2015/601624. Epub 2015 Sep 8.
Background. Tuberculosis of the penis (TBP) is rare. Aim. To review the literature. Method. Various internet data bases were searched. Literature Review. TBP could be primary or secondary, may develop following circumcision performed by a person who had pulmonary Tb, and may be transmitted to the penis from ejaculation, contamination from clothing, or from contact with endometrial secretions, following an earlier pulmonary Tb or Tb elsewhere. TBP presents with a painless/painful small nodule, ulcer, mass on penis which gradually enlarges, and induration/swelling of penis, with or without erectile dysfunction. Inguinal lymph nodes may or may not be palpable. The patient's voiding is normal. There may or may not be history of circumcision, pulmonary Tb, and BCG immunization. TBP mimics penile carcinoma, granulomatous syphilis penile ulcer, genital herpes simplex, granuloma inguinale, and HIV infection. Diagnosis is established by microscopic examination finding of granulomas +/-AFB in penile discharge or biopsy of lesion or culture of Tb organism from discharge or biopsy specimens or positive Elisa serology/PCR for Tb. PTBs respond to first- or 2nd-line anti-Tb 6-month treatment. Close contacts should be screened. Extrapulmonary Tb should be excluded. Conclusions. Clinicians should consider possibility of PTB in cases of penile lesions and erectile failure.
背景。阴茎结核（TBP）较为罕见。目的。回顾相关文献。方法。检索了各种互联网数据库。文献综述。阴茎结核可为原发性或继发性，可能在由患有肺结核的人进行包皮环切术后发生，也可能在先前患有肺结核或身体其他部位结核后，通过射精、衣物污染或接触子宫内膜分泌物传播至阴茎。阴茎结核表现为阴茎上有无痛/疼痛的小结节、溃疡、肿物，且逐渐增大，伴有或不伴有阴茎硬结/肿胀，可有或无勃起功能障碍。腹股沟淋巴结可能可触及，也可能不可触及。患者排尿正常。可能有或没有包皮环切术、肺结核及卡介苗接种史。阴茎结核可类似阴茎癌、肉芽肿性梅毒阴茎溃疡、生殖器单纯疱疹、腹股沟肉芽肿及HIV感染。通过在阴茎分泌物中显微镜检查发现肉芽肿+/-抗酸杆菌、病变活检、分泌物或活检标本中结核分枝杆菌培养或结核酶联免疫吸附测定/聚合酶链反应阳性来确诊。阴茎结核对一线或二线抗结核6个月治疗有反应。应对密切接触者进行筛查。应排除肺外结核。结论。临床医生在遇到阴茎病变和勃起功能障碍病例时应考虑阴茎结核的可能性。
