What is it?

Tuberculosis of the genitourinary system, or urogenital TB, is an extrapulmonary manifestation of tuberculosis. It is caused by an infection by Mycobacterium tuberculosis complex. The renal and urologic tuberculosis involves the collecting system and less commonly the renal parenchyma. Genital tuberculosis involves epididymis, testis, urethra, and prostate in the male and Fallopian tube, endometrium, and ovaries in the female. Urogenital TB can present with a range of clinical manifestations, from asymptomatic, through subclinical, non-specific symptoms and signs, to obstructive uropathy and renal failureThis diagnosis is often missed or diagnosed late because of chronic and non- specific symptoms and lack of awareness among clinicians. Risk factors include malnutrition, HIV infection, smoking, homelssness, poor housing, pneumoconiosis, immunosuppressive drugs and kidney diseases. Complications of non- treated genitourinary TB may include ureteral strictures, contracted bladder, obstructive nephropathy, renal parenchymal destruction, irreversible organ damage and end-stage renal failure.

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Signs & symptoms

Symptoms and signs of urogenital TB vary and depends on the site of infection- many patients are asymptomatic, others symptoms may include dysuria, urinary hesitancy and frequency, flank pain, fever, weight loss, night sweats, hematuria, chronic pelvic pain, difficulty in urination , nocturia, haematospermia, sexual dysfunction, infertility and more.


Diagnosis is made by identification of Mycobacterium tuberculosis in culture or by identification of its DNA. Tuberculin skin test or the Mantoux test can detect an infection, as well as interferon-gamma release assay that can quantify its response to the antigens. Urinalysis may show culture-negative, sterile pyuria and microscopic or macroscopic haematuria. Other diagnosis tools may include upper tract imaging, cystoscopy, microbiological investigations, tissue biopsy and histological examination.


Urogenital tuberculosis treatment is treated like pulmonary TB- with 4 drugs (rifampin, isoniazid, pyrazinamide, and ethambutol) for 6 months. Sometimes, a longer treatment may be required either because of coinfection with HIV or kidney abscess. For multidrug-resistant TB (MDR-TB) infection, the treatment is with fluoroquinolones, aminoglycosides, and other drugs for 18 to 24 months.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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