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Male genital tuberculosis in Siberians
Ekaterina Kulchavenya1, Victor Khomyakov
1Novosibirsk Research TB Institute, 107/1 Kubovaya str. ap. 57, 630040 Novosibirsk, Russia. ekaterina_k@online.nsk.su
Abstract:
To study the epidemiology and the clinical picture of male genital tuberculosis in Siberia, Russia. Five hundred and fourteen patients with genitourinary tuberculosis were enrolled in the study: 414 had kidney tuberculosis only, 100 had genital involvement. The clinical picture and structure of genital tuberculosis were investigated: 42 had tuberculosis of scrotal organs and 58 had tuberculosis of the prostate. Urinary cultures, urinalysis, three-glass test, and investigation of the prostate secretion, Mycobacteria culture, and susceptibility testing were performed in all 514 patients. 33.6% of all patients earlier suffered from pulmonary or extrapulmonary tuberculosis and were successfully cured. In 61.9% nephrotuberculosis was diagnosed alongside with an orchiepididymitis. In 30.9% of patients bilateral epididymorchitis was diagnosed. Mycobacteriuria was present in 38.1%. Scrotal fistula was found in 11.9%. In 66.7% the symptoms appeared acutely. Half of the patients with prostate tuberculosis complained of dysuria, 23 (39.6%) had perineal pain, 34 (58.6%) had flank pain. Leucocytes in urine were present in 49 (84.5%) patients, and in prostatic secretion in 45 (77.6%) patients. Erythrocytes in urine were present in 31 (53.4%) patients, and in prostatic secretions in 17 (29.3%) patients. Male genital tuberculosis has no specific pathognomonic signs. Using a special algorithm for the management of patients with prostatitis or epididymitis is recommended.
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