Genitourinary tuberculosis: clinical profile, diagnostic approach and treatment outcome in a tertiary care center of North India
Keywords:GUTB: Genitourinary tuberculosis, NAATs: Nucleic Acid Amplification Tests, DJ Stenting: Double J Stenting, PCN: Percutaneous Nephrostomy
Introduction:Genitourinary tuberculosis (GUTB) is the second commonest form of extrapulmonary tuberculosis with more than 90% of cases occurring in developing countries and kidney being the most common site of involvement. We present clinico-epidemiological profile of patients and management of genitourinary tuberculosis in IGMC Shimla.Material and methods: We conducted cross sectional record-based study of patients diagnosed and treated for genitourinary tuberculosis in the Department of Urology, IGMC Shimla from January 2017 to November 2020.
Results: Eighty-six patients were treated for GUTB and mean age of patients was 42.2 years (18-78 years). In clinical presentation, irritative voiding symptoms i.e., frequency and dysuria (80.23% and 46.51% respectively) were the most common, followed by flank pain and weight loss (40.69% each), further followed by low grade fever (34.88%) and hematuria (33.72%). All patients were started on ATT from DOTS center and then were transferred to local DOTS units of their respective districts. Three patients required modification of ATT due to significant side effects. One patient died as a result of complications related to ATT and comorbid illness.Ultrasound guided percutaneous nephrostomy (PCN), Double J stenting and pigtail drainage for psoas abscess was done in 24 (27.91%) patients, 22 (25.58%) patients and in 8 (9.3%) patients respectively. Reconstructive surgery was done in 25 patients i.e., ureteroureterostomy in 3 (3.48%) patients, ureteric reimplant in 14 patients (16.27%) patients ,augmentation ileocystoplasty in 4 (4.65%) patients, Boari flap in 4 (4.65%) patients. Nephrectomy was done in 3 (3.48%) patients and cystectomy with ileal conduit was done in 3 (3.48%) patients. Conclusion: GUTB is a prevalent disease in our country although data regarding GUTB is quite limited. GUTB complaints are mostly trivial and nonspecific but consequences are grave. Proper early diagnosis and timely management can prevent morbidity and potential mortality in these patients. Timely intervention and reconstructive surgery is required in a significant number of patients to preserve kidney, ureter, and urinary bladder function.
How to Cite
Copyright (c) 2021 Pamposh Raina, Girish Kumar Sharma, Manjeet Kumar, Kailash Chander Barwal, Kirti Rana, Sanjeev Chauhan
This work is licensed under a Creative Commons Attribution 4.0 International License.