Male genitourinary tuberculosis--13 years experience at a tertiary care center in India

We conducted a retrospective study of genitourinary tuberculosis (TB) among males attending a hospital in the northern Himalayan region of India. Records from 1 January 1997 to 31 December 2009 were reviewed for clinical history, relevant radiological findings laboratory data, histopathology and treatment. Of the 1,113 male urogenital non-neoplastic specimens received at the histopathology laboratory of the hospital, tuberculosis was diagnosed in 25 cases (2.2%). Urinary bladder and prostate were the most common organs involved. Thirty-six percent of cases had a previous history of TB; 12% of cases presented with no symptoms. Ziehl-Neelsen staining was positive in 72% of cases. Cultures were positive for TB in 42.8% of cases and polymerase chain reaction was positive in two cases in which it was performed. Antituberculosis treatment was required for up to 12 months in some cases and surgery was required in 32% of cases. Genitourinary TB in this study had varying presentations. Cases having strong clinical and radiological findings and suggestive histopathology for tuberculosis, even without demonstration of mycobacteria may be considered for TB treatment, particularly in endemic areas. Patients living in more remote areas may have more specific and severe symptoms due to late presentation. Histopathology plays a crucial role in diagnosis due to lack of sophisticated techniques. The emphasis should be on early detection followed by prompt treatment to avoid further complications.