Urological manifestations of HIV infection

HIV-1 disease is associated with many infectious and neoplastic complications. This is particularly true of the genitourinary tract, where high rates of renal disease, neoplasms, voiding and erectile dysfunction, hematuria, opportunistic genitourinary infections, and epididymo-orchitis are found in HIV-1-infected individuals. Recent experience at Ben Taub General Hospital (Houston, TX) shows that men requiring admission to the urologic service for treatment of genitourinary disorders have high rates of HIV-1 seropositivity, particularly in the setting of epididymo-orchitis, where 21 of 106 (20%) were found to be HIV-1 infected. These men were significantly more likely to require surgical treatment and to harbor resistant bacteria in infected tissues. Importantly, for 15 of 21 HIV-1-infected men, epididymo-orchitis was the first clinical manifestation of HIV-1 disease, and 6 were first found to be HIV-1 seropositive during that admission. Our experience illustrates the critical importance of screening for HIV-1 infection in the setting of genitourinary disease.