A 20-Year Single-Centre Experience on Urogenital Tuberculosis

Urogenital tuberculosis (UGTb) is the second most common form of extrapulmonary Tb. We aimed to evaluate the clinical consequences in our 20-year experience of UGTb.

We retrospectively reviewed the files of consecutive patients diagnosed with UGTb through microbiological methods between January 2001 and April 2021 in our centre. Clinical and demographic data of the patients were assessed. Surgical procedures during the disease course were also noted.

A total of 46 patients (26 males) having a median age of 48.5 (16-82) years were diagnosed with UGTb. The most frequent complaint at admission was lower urinary tract symptoms (LUTS), followed by nonspecific symptoms, macroscopic hematuria, flank pain, scrotal swelling, and infertility. A history of pulmonary Tb was present in 10 patients. The kidney was the most affected organ, followed by ureter, bladder, and testis/epididymis. Bladder involvement and admission with LUTS was significantly higher in elderly patients (≥60 years), whereas the rate of nonspecific symptoms was significantly higher in younger patients (≤40 years). Eleven patients required surgical interventions including nephrectomy (n = 5), nephroureterectomy (n = 2), orchiectomy (n = 1), epididymectomy (n = 1), distal ureterectomy + ureteroneocystostomy (n = 1), and epididymovasostomy (n = 1). Among the 32 patients with at least 12 months of follow-up (median 114 months, range: 12-180) four had ongoing LUTS, 5 had chronic kidney disease, one had end-stage renal disease, and one had azoospermia.

UGTb affected the upper urinary tract with a fair chance of renal function deterioration in addition to LUTS and infertility. These conditions may impair the patient's long-term quality of life. Elderly patients were also more prone to bladder involvement, and approximately one-quarter of patients with UGTb required surgical intervention.