These days, genitourinary tuberculosis (GUTB) rarely occurs in conjunction with pulmonary tuberculosis. Reconstructive surgery for GUTB has also decreased but may still be done in case of a grossly distorted genitourinary anatomy and dysfunction that are unlikely to regress with chemotherapy alone. Reconstructive bladder surgery for GUTB is a well-established procedure. The various complications associated with the reconstructive surgery have also been well documented. We present a case of an uncommon complication after ileocystoplasty.
Drug Therapy ; Tuberculosis* ; Tuberculosis, Pulmonary ; Tuberculosis, Urogenital ; Urinary Bladder* ; Urinary Diversion

Extrapulmonary tuberculosis usually involves the pleura, central nervous system, lymphatic system, genitourinary system and bone with joint. There are few reports about pulmonary tuberculosis involving the endometrium and muscle. A 32-year-old woman who had intact immunity visited hospital due to menorrhagia, and was diagnosed with endometrial tuberculosis. The patient also had a painless abdominal mass about for 1 year before she came to the hospital. She was diagnosed with rectus abdominis muscle tuberculosis, endometrial tuberculosis, and pulmonary tuberculosis at the same time. We report a case of endometrial tuberculosis accompanied with rectus abdominis muscle and pulmonary tuberculosis in a non-immunosuppressed person.
Adult ; Central Nervous System ; Endometrium* ; Female ; Humans ; Joints ; Lung* ; Lymphatic System ; Menorrhagia ; Pleura ; Rectus Abdominis* ; Tuberculosis* ; Tuberculosis, Pulmonary ; Urogenital System

BACKGROUND: Amenorrhea may occur in patients with lupus treated with cyclophosphamide. This is commonly attributed to primary ovarian failure leading to infertility -- a possible complication of cyclophosphamide. Urogenital tuberculosis (TB) can be a rare cause of amenorrhea and infertility in lupus patients.
OBJECTIVE: To present a case of endometrial TB causing amenorrhea and abnormal uterine bleeding in a patient with lupus nephritis treated with cyclophosphamide.
CASE: A 32-year-old Filipino female, who was diagnosed with lupus nephritis, was managed with high dose steroid and intravenous (IV) cyclophosphamide. Lupus nephritis improved with treatment, but she subsequently developed amenorrhea and vaginal spotting for two months. Symptoms were initially attributed to premature ovarian failure due to cyclophosphamide.Gynecologic examination showed thickened endometrium with normal ovaries and uterus on ultrasound. Dilatation and curettage was performed. Histopathology of endometrial curetting revealed chronic granulomatous endometritis with Langhans giant cells. Endometrial TB was diagnosed, and anti-Koch's therapy was started. The patient showed a favourable response, with resumption of normal menstruation after only the first month of treatment.
CONCLUSION: This paper emphasizes the importance of considering a wide range of differential diagnosis for gynecologic symptoms in patients with lupus. Tuberculosis should be considered in areas of high endemicity

Human ; Female ; Adult ; Primary Ovarian Insufficiency ; Lupus Nephritis ; Endometritis ; Amenorrhea ; Giant Cells, Langhans ; Cyclophosphamide ; Menopause, Premature ; Tuberculosis, Urogenital ; Infertility ; Uterine Hemorrhage

PURPOSE: To evaluate the feasibility of the interferon-gamma release assay (IGRA) as a supplementary diagnostic tool for the diagnosis of genitourinary tuberculosis (GUTB). MATERIALS AND METHODS: Fifty-seven patients who were tested with the IGRA to diagnose GUTB were included. All patients had clinical or radiologic features suspicious for GUTB. Signs and symptoms included chronic dysuria with long-standing sterile pyuria, renal calcification with distorted renal calyces and contracted renal pelvis, and chronic epididymitis. Patients who had a history of tuberculosis in other organs were excluded. Tests including IGRA, urine acid-fast bacilli (AFB) stain and culture, urine tuberculosis polymerase chain reaction (UT-PCR), and radiological examinations were performed to confirm GUTB. The medical records of the patients were reviewed retrospectively. RESULTS: The IGRA result was positive in 30 patients (52.6%). The results of the urine AFB stain and culture were positive in 5 patients (8.8%) and 7 patients (12.2%), respectively. The results of UT-PCR were positive in 9 patients (15.8%). The 7 patients who showed positive results in the urine AFB stain and culture also had positive results on the IGRA. A UT-PCR-negative patient was diagnosed with GUTB by positive results on both the IGRA and AFB stain and culture. CONCLUSIONS: The IGRA might feasibly be used as a supplementary or screening tool for the diagnosis of GUTB in addition to urine AFB stain and culture. Further studies for statistical evaluation of its sensitivity, specificity, and efficacy are needed.
Contracts ; Dysuria ; Epididymitis ; Humans ; Interferon-gamma ; Interferon-gamma Release Tests ; Kidney Pelvis ; Male ; Mass Screening ; Medical Records ; Polymerase Chain Reaction ; Pyuria ; Sensitivity and Specificity ; Tuberculosis ; Tuberculosis, Urogenital

PURPOSE: This study was conducted to analyze the clinical characteristics and treatments of patients with genitourinary tuberculosis (GUTB) over the past 10 years. MATERIALS AND METHODS: The study population comprised 101 patients who were diagnosed with GUTB and hospitalized from January 2000 to December 2009. Acid-fast bacilli (AFB) smear, urine tuberculosis culture, urine tuberculosis polymerase chain reaction (PCR), intravenous urography, cystoscopy, and histopathologic findings were used for patient selection. Yearly proportion, gender, patient distribution according to age, history of tuberculosis, and presence of other organ tuberculosis were analyzed. RESULTS: The patients hospitalized with GUTB counted for 0.9% of all patients admitted to the department of urology. The sex ratio was 1:1.53 (male:female), and the patients' mean age was 45.57+/-12.55 years (range, 19-81 years). Among the patients, there was one immunocompromised patient. A total of 22 patients (21.8%) had a medical history of tuberculosis, mostly pulmonary tuberculosis (90.9%). The sensitivity of AFB stain, tuberculosis culture, and PCR was 41.6%, 55.4%, 33.7%, respectively. A total of 54 patients required additional surgical treatment: 30 cases of nephrectomy, 8 cases of epididymectomy, 8 cases of ureteral stent, 5 cases of nephrostomy, 1 case of ureterectomy, 1 case of augmentation cystoplasty, and 1 case of transurethral resection of prostate. CONCLUSIONS: The frequency of GUTB tended to decrease progressively. However, GUTB is still a threat to public health. There was no previous history of tuberculosis in two-thirds of the cases of GUTB and more than half of them required further surgical treatment.
Cystoscopy ; Humans ; Immunocompromised Host ; Nephrectomy ; Patient Selection ; Polymerase Chain Reaction ; Prevalence ; Public Health ; Sex Ratio ; Stents ; Tuberculosis ; Tuberculosis, Pulmonary ; Tuberculosis, Urogenital ; Ureter ; Urography ; Urology

Next to lymphatic involvement, genitourinary tuberculosis is considered the second most common manifestation of extrapulmonary tuberculosis worldwide. However, testicular and spermatic cord involvement is uncommon. We report here on a case of testicular and spermatic cord tuberculosis that masqueraded as testicular cancer. A 25-year-old man was admitted to our hospital with painless right scrotal swelling for past 2 months. The abdominal CT scan showed a heterogenous testicular mass that was suspicious for being malignancy. He underwent right radical orchiectomy; testicular and spermatic cord tuberculosis was revealed on histopathological examination. This case highlights the importance of taking a thoughtful diagnostic approach for testicular and spermatic cord tuberculosis, including fine needle aspiration before performing surgical exploration.
Adult ; Biopsy, Fine-Needle ; Humans ; Spermatic Cord ; Testicular Neoplasms ; Tuberculosis ; Tuberculosis, Urogenital ; Urogenital Neoplasms

OBJECTIVE: This study aimed to determine clinical characteristics that are associated with tuberculosis orchitis in patients who present with a testicular mass.

MATERIALS AND METHODS: This is an analytic retrospective cohort study of patients who underwent radical orchiectomy for a possible testicular malignancy based on a testicular mass from 2005 to 2009. The following data were derived from a review of the patient's charts: patient age, laterality of the disease, duration of symptoms, concomitant extra-testicular tuberculosis (TB), pre-operative anti-TB treatment received, pertinent pre-operative physical findings, pertinent diagnostics done pre-operatively, and intra-operative findings.

RESULTS: The prevalence of testicular tuberculosis in persons who underwent radical orchiectomy for a scrotal mass is 31.8%. TB orchitis occurs more often in younger patients, those who have had tuberculosis in the past, or have received treatment, those with larger testicular masses, those with scrotal skin sinus and tenderness or swelling, tunica, vaginalis invasion, scrotal skin invasion, and epididymal enlargement, and those with cheesy substance noted in intraoperative findings. There were no significant differences between testicular tuberculosis and testicular tumor in terms of ultrasound findings.

CONCLUSION: Testicular tuberculosis is prevalent among patients who underwent radical orchiectomy due to a scrotal mass. Several clinical characteristics preoperatively and intraoperatively may predict TB orchitis in these patients.

Human ; Male ; Aged 80 and over ; Aged ; Middle Aged ; Adult ; Young Adult ; Adolescent ; Child ; Child Preschool ; Infant ; Orchitis ; Testicular Diseases ; Male Urogenital Diseases ; Orchiectomy ; Tuberculosis-history

Tuberculous epididymitis is a rare urological disease difficult to diagnose. The conventional methods for diagnosis are often time-consuming and invasive. The combined use of scrotal magnetic resonance imaging (MRI) and urinary polymerase chain reaction (PCR)-based assay for mycobacterial DNA (the latter because of its high sensitivity and specificity to demonstrate mycobacterial DNA) is a valuable method for rapid diagnosis of tuberculous epididymitis. We report a 79-year-old man who was admitted with the chief complaints of bilateral scrotal swelling and pain. The combined use of scrotal MRI and urinary PCR allowed prompt diagnosis of tuberculous epididymitis and adequate antituberculous therapy.
Aged ; DNA, Bacterial ; genetics ; Epididymitis ; diagnosis ; microbiology ; Humans ; Magnetic Resonance Imaging ; Male ; Mycobacterium tuberculosis ; genetics ; isolation & purification ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Tuberculosis, Urogenital ; diagnosis ; microbiology

Amyloidosis is a disease characterized by deposition of amorphous and insoluble fibrillar protein in various tissues and organs, but its productive mechanism has not been established yet. Enlargement and functional disturbance of infiltrated organs result in various clinical symptoms. Primary amyloidosis usually involve tongue, heart, nerve, gastrointestinal tract, ligament, skin, and bone marrow without underlying disease. Secondary amyloidosis is associated with chronic inflammatory disease such as tuberculosis, urogenital infection, rheumatoid arthritis, chronic ulcerative colitis, myelitis, 3rd syphilis and leprosy. The authors had experienced a case of secondary amyloidosis associated with rheumatoid arthritis, especially involving heart. He had suffered from rheumatoid arthritis for 17 years and admitted because of generalized edema and dyspnea. This case was confirmed by endomyocardial biopsy and immunohistochemical stain showed AA type. We treated him conservatively and he was transferred to other hospital on the 25th day of hospitalization but died suddenly after twelve hours.
Amyloidosis* ; Arthritis, Rheumatoid ; Biopsy ; Bone Marrow ; Colitis, Ulcerative ; Dyspnea ; Edema ; Gastrointestinal Tract ; Heart* ; Hospitalization ; Leprosy ; Ligaments ; Myelitis ; Skin ; Syphilis ; Tongue ; Tuberculosis, Urogenital

During 5 years from January 1995 to December 1999, in the Department of Urology of B×nh D©n hospital, we have treated 193 cases of urogenital tuberculosis coming from South Vietnam in which there were 86 cases (44.55%) with complication of ureteral stenosis in many different forms and degrees. The most common stenotic lesions were pelvic and juxtavesical stenosis (61.62%), the mid-ureteral stenosis and uretero - pelvic stenosis were rare (8.13% and 1.16%, respectively), or segmental stenosis (20.93%). In 86 cases of ureteral stenosis, there were 13 cases (15.115) with concomitant deterioration of the ipsilateral kidney. Treatment for this specific complication of the disease usually faces many difficulties, because of many internal and external causes.
Urethral Diseases ; Tuberculosis, Urogenital ; therapeutics