Centre for Biotechnology, Maharshi Dayanand University, Rohtak, India.
Expert Rev Anti Infect Ther. 2021 Oct;19(10):1175-1190. doi: 10.1080/14787210.2021.1902305. Epub 2021 May 4.
: Urogenital tuberculosis (UGTB) is a common manifestation of extrapulmonary TB (EPTB), which affects both men and women in a ratio of 2:1. Similar to other EPTB types, diagnosis of UGTB is quite challenging owing to atypical clinical presentation and paucibacillary nature of specimens. This review is primarily focused on the current updates developed in the diagnosis of male UGTB.: Smear/culture, imaging, histopathology, and interferon-γ release assays are the main modalities employed for detecting male UGTB cases. Moreover, we described the utility of nucleic acid amplification tests (NAATs), including loop-mediated isothermal amplification, PCR, nested-PCR, and GeneXpert (MTB/RIF) assays. The possibility of using other novel modalities, such as immuno-PCR (I-PCR), aptamer-linked immobilized sorbent assay (ALISA), and identification of circulating cell-free DNA (cfDNA) by NAATs were also discussed.: The current methods used for the diagnosis of male UGTB are not adequate. Therefore, the latest molecular/immunological tools, . Xpert Ultra, Truenat MTB, I-PCR, ALISA, and cfDNA detection employed for the diagnosis of other EPTB forms and pulmonary TB may also be exploited for UGTB diagnosis. Reliable and timely diagnosis of male UGTB may initiate an early start of anti-tubercular therapy that would reduce infertility and other complications associated with disease.
: 泌尿生殖系统结核病(UGTB)是肺外结核病(EPTB)的常见表现,男女发病比例为 2:1。与其他 EPTB 类型一样,由于临床表现不典型和标本菌量少,UGTB 的诊断极具挑战性。本篇综述主要聚焦于男性 UGTB 诊断方面的最新进展:涂片/培养、影像学、组织病理学和干扰素-γ释放试验是用于检测男性 UGTB 病例的主要方法。此外,我们还描述了核酸扩增试验(NAATs)的应用,包括环介导等温扩增、PCR、巢式-PCR 和 GeneXpert(MTB/RIF)检测。还讨论了使用其他新型方法的可能性,如免疫-PCR(I-PCR)、适配体连接固定吸附剂测定法(ALISA)和 NAATs 检测循环无细胞 DNA(cfDNA)。目前用于男性 UGTB 诊断的方法并不完善。因此,可利用最新的分子/免疫工具,如 Xpert Ultra、Truenat MTB、I-PCR、ALISA 和 cfDNA 检测,这些方法也可用于诊断其他 EPTB 形式和肺结核,以提高男性 UGTB 的诊断率。可靠和及时的男性 UGTB 诊断可以早期开始抗结核治疗,从而降低与疾病相关的不孕和其他并发症的发生风险。