Kulchavenya E V, Shevchenko S Yu, Kholtobin D P
TB Research Institute of Ministry of Health of Russia, Novosibirsk, Russia.
FGBOU VO Novosibirsk State Medical University of Ministry of Health of Russia, Novosibirsk, Russia.
Urologiia. 2020 Nov(5):15-19.
Tuberculosis is an infectious disease, which can result in self-cure, chronic process or relapse course.
To analyze the incidence of recurrence of urogenital tuberculosis and to identify the features of patients with recurrent disease.
Specially developed questionnaires on the structure of the incidence of extrapulmonary tuberculosis in the Siberian Federal District and the Far Eastern Federal District were analyzed. We also studied 140 outpatient medical records of patients with tuberculosis of the urinary tract and male reproductive system, who was followed at the Novosibirsk Regional TB Outpatient Department. The medical records of patients with recurrent disease were analyzed in detail.
In 2019, 563 patients with isolated extrapulmonary tuberculosis in the Siberian Federal District and the Far Eastern Federal District were identified, and 14.4% of them had urogenital tuberculosis. In 99 (17.6%) patients, the present state was a relapse, while urogenital tuberculosis occupied 8.1%, and all patients were HIV-negative. In the Novosibirsk Region, 127 out of 140 patients were diagnosed with urogenital tuberculosis for the first time, and in 13 (9.3%) had recurrent disease. Among patients with relapse, male predominated (61.5%). The primary focus of tuberculosis was located in the genitourinary system in 53.9% of patients, which supports the theory of reactivation of dormant foci. In addition, 38.5% of patients with primary episode of tuberculosis were smear-positive. The average relapse time after successful cure of tuberculosis was 9.1 years. Among patients with recurrent urogenital tuberculosis, mycobacteriuria was recorded in 23.1% of cases, and in one case drug resistance of the pathogen to streptomycin and isoniazid was seen. In general, the kidneys were the most susceptible to relapses and were involved in 69.2% of cases.
Nearly 8.1-9.3% of patients with genitourinary tuberculosis had previously tuberculosis and were successfully cured. When urogenital tuberculosis recurs, the kidneys are affected in 69.2% of cases. The overwhelming majority (61.5%) of patients with recurrent genitourinary tuberculosis are men, therefore gender can be considered a predictor of recurrence. HIV infection was found in isolated cases in patients with both newly diagnosed and recurrent urogenital tuberculosis.
