Clinical Characteristics and Treatment on Genitourinary Tract Tuberculosis during Recent 15 Years

Yi, Jeong Won; Lee, Sun Ju; Lee, Choong Hyun; Kim, Jin Il; Chang, Sung Goo

Abstract

BACKGROUND: The incidence of genitourinary tuberculosis has consistently declined as results of effective chemotherapy and health care. However, it still is associated with significant morbidity and requires surgery. Therefore, we analyzed the clinical characteristics, diagnosis, and treatment of patients with genitourinary tuberculosis during recent 15 years.
MATERIALS AND METHODS
From January 1, 1988 to December 31, 2002, 142 patients were admitted with genitourinary tuberculosis. We retrospectively analyzed the clinical data of all the patients.
RESULTS
Incidence of genitourinary tuberculosis in patients admitted to urologic department was 0.8%. Male to female ratio was 1.4:1 and it most commonly occurred in the 4th decade. Previous history of tuberculosis was noted in 51 patients (36%), most of which were pulmonary tuberculosis (80.4%). The sensitivity of AFB smear, culture, and polymerase chain reaction (PCR) was 39%, 50%, and 31%, respectively. Among 24 patients with negative AFB smear and culture, 6 patients (24%) were positive for PCR. Short term chemotherapy was given to most of the patients, and there were no relapse or serious side effect. Additional surgical procedures were required in 89 patients (62.7%):nephrectomy in 54 patients (38%), ureterectomy and ureteral reconstruction in 1 patient (0.7%), nephrostomy in 9 patients (6.3%), ureteral stent in 11 patients (7.7%), epididymectomy and/or orchiectomy in 15 patients (10.5%), incision and dainage in 1 patients (0.7%), and TUR-P in 2 patients (1.4%).
CONCLUSION
The incidence of genitourinary tuberculosis has decreased recently, but the disease still threatens public health. Because a large part of genitourinary tuberculosis had no previous tuberculous lesions and reguired surgical procedures, this facts emphasize doctor's role on prevalence and management of genitourinary tuberculosis.