Kholtobin D P, Kulchavenya E V
TB Research Institute of Minzdrav of Russia, Novosibirsk, Russia, Novosibirsk State Medical University of Minzdrav of Russia, Novosibirsk, Russia.
Urologiia. 2017 Oct(5):100-105. doi: 10.18565/urology.2017.5.100-105.
Urogenital tuberculosis does not have pathognomonic symptoms, so diagnostic errors are quite common. This systematic review of literature was conducted to identify the causes and estimate the incidence of erroneous diagnoses. We critically evaluated some articles in which the authors describe observations of urogenital tuberculosis as rare and unusual because they never encountered this disease, but in fact that were typical manifestations of genitourinary tuberculosis. The authors analyzed and illustrated the features of urinary tuberculosis in patients with pulmonary tuberculosis, differential diagnosis of urogenital tuberculosis and kidney cancer and male genitourinary organs, described errors in the diagnosis of urethral, testicular, penile, prostatic and epididymal tuberculosis. Urolithiasis was described as a mask and concomitant disease of urogenital tuberculosis. Really rare forms of bladder tuberculosis as the cause of diagnostic errors are described. Examples of fatal outcomes of urogenital tuberculosis are given. The authors analyzed cases of granulomatous interstitial nephritis due to tuberculosis infection and tuberculosis of the renal artery as the cause of renovascular hypertension. The most common causes of late diagnosis of urogenital tuberculosis are the absence of a typical pattern and the tendency to manifest under the guise of other diseases.
泌尿生殖系统结核没有特征性症状，因此诊断错误相当常见。本系统文献综述旨在确定错误诊断的原因并估计其发生率。我们批判性地评估了一些文章，其中作者将泌尿生殖系统结核的观察描述为罕见和不寻常，因为他们从未遇到过这种疾病，但实际上这些都是泌尿生殖系统结核的典型表现。作者分析并阐述了肺结核患者泌尿结核的特征、泌尿生殖系统结核与肾癌及男性泌尿生殖器官的鉴别诊断，描述了尿道、睾丸、阴茎、前列腺和附睾结核诊断中的错误。尿路结石被描述为泌尿生殖系统结核的一种掩盖性和伴随性疾病。还描述了真正罕见的膀胱结核形式作为诊断错误的原因。给出了泌尿生殖系统结核致命结局的例子。作者分析了结核感染导致的肉芽肿性间质性肾炎病例以及肾动脉结核作为肾血管性高血压病因的情况。泌尿生殖系统结核延迟诊断的最常见原因是缺乏典型模式以及倾向于以其他疾病的形式表现出来。
