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Genitourinary tuberculosis: a profile of 55 in-patients
N P Buchholz1, S Salahuddin, R Haque
1Department of Surgery (Urology), Aga Khan University, Karachi.
Objective:
To outline the pattern and trends in major cases of genito-urinary tuberculosis (GUTB) which require hospital treatment.
Method:
We retrospectively reviewed 55 patients with proven GUTB who were treated as in-patients in a major referral hospital in Pakistan.
Results:
The male/female ratio was 3:1. Prevailing symptoms were lower urinary tract symptoms, flank pain, gross hematuria and fever. A urine culture was positive for tuberculosis (TB) in 57%, bladder biopsies in 54%. For renal TB, intravenous urogram (IVU) and ultrasound were suggestive in about 50% of cases. Ultrasound was very helpful in the diagnosis of testicular TB. Patients underwent surgery in 36% of cases. In contrast to the general trend reported worldwide, surgery was mainly ablative rather than re-constructive. Patient compliance in clinical follow-up and drug therapy was poor.
Conclusion:
Surgery for GUTB in Pakistan is still mainly ablative, probably due to a high number of complicated and progressed cases. To date, therapy of GUTB is mainly based on anti-tuberculosis chemotherapy (ATT). However, huge efforts will be required to improve patient compliance without which every therapeutic approach will remain futile.
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