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A Tuberculosis Molecular Bacterial Load Assay (TB-MBLA)
Published on: April 30, 2020
An update on lower urinary tract tuberculosis
Gilbert J Wise1, Alex Shteynshlyuger
1Division of Urology, Maimonides Medical Center, 48-02 Tenth Avenue, Brooklyn, NY 11219, USA. gwise@maimonidesmed.org
Current Urology Reports
|September 4, 2008
Summary
Genitourinary tuberculosis often presents atypically, frequently affecting the lower tract. Diagnosis involves identifying acid-fast bacilli, and treatment may require surgery beyond medication.
Area of Science:
- Urology
- Infectious Diseases
- Microbiology
Background:
- Genitourinary tuberculosis (GUTB) exhibits atypical clinical presentations.
- Pulmonary tuberculosis history is present in only 20-30% of GUTB patients.
- GUTB predominantly affects the lower genitourinary system, including the epididymis, testis, bladder, and prostate.
Purpose of the Study:
- To review the epidemiology, clinical manifestations, diagnosis, and management of genitourinary tuberculosis.
- To highlight the atypical presentations of GUTB, particularly in the lower genitourinary tract.
- To emphasize the diagnostic challenges and treatment strategies for GUTB.
Main Methods:
- Review of literature on genitourinary tuberculosis.
- Analysis of clinical presentations, diagnostic methods, and treatment outcomes.
- Discussion of the role of bacillus Calmette-Guérin (BCG) therapy in iatrogenic GUTB.
Main Results:
- Lower genitourinary tract involvement is more common than renal tuberculosis.
- Common symptoms include irritative voiding issues, hematuria, and epididymo-orchitis.
- Diagnostic tools include urinalysis (sterile pyuria, hematuria), acid-fast bacilli identification (culture, PCR), and tissue analysis.
- Infertility can result from GUTB affecting seminal vesicles, vas deferens, fallopian tubes, or uterus.
- BCG therapy for bladder cancer is a potential cause of symptomatic GUTB.
Conclusions:
- Genitourinary tuberculosis requires a high index of suspicion due to its varied presentations.
- Early and accurate diagnosis through microbiological and pathological examination is crucial.
- Management often necessitates a combination of anti-tuberculosis medication and surgical intervention for definitive treatment and reconstruction.
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