Skip to main content

Diagnostic of Urogenital Tuberculosis

  • Chapter
  • First Online:
Urogenital Tuberculosis: Epidemiology, Diagnosis, Therapy
  • 726 Accesses

Abstract

Diagnosis of EPTB and, particularly, UGTB in-time is very difficult task, as the disease has no specific features or laboratory findings, excluding Mtb identification – and in some cases it is impossible to reveal Mtb. So diagnosis should be as result of complex measures. Very simple and cheep things – like careful study of epidemic history and 3-glass test of urinalysis – may be helpful in diagnostic of UGTB. An otherwise expensive and time-consumpting examination is necessary for correct diagnosis – including bacteriology, pathohistology, biopsies, provocative tests etc. We recommend following detailed algorithm in difficult cases.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Aslan G, Doruk E, Emekdaş G, Serin MS, Direkel S, Bayram G, Durmaz R (2007) Isolation and identification of Mycobacterium tuberculosis from the urine samples by conventional and molecular methods. Mikrobiyol Bul 41(2):185–192

    PubMed  CAS  Google Scholar 

  • Barisic Z, Vraslovic-Carevic N, Milostic K, Alfirevic D, Babic-Erceg A, Borzic E, Zoranic V, Kaliterna V, Carev M (2003) Tuberculous orchiepididymitis diagnosed by nucleic acid amplification test: a case report. Int Urol Nephrol 35:203–205

    Article  PubMed  Google Scholar 

  • Batyrov FA, Nersesyan AA, Merkur’eva Ya A (2004) Urogenital tuberculosis: problem of diagnostic and treatment novo day. Urologiia 5:16–24

    PubMed  Google Scholar 

  • Bereza ЕА, Gioev AZ (2011) Diagnostic of urogenital tuberculosis with MSCT with bolus enforsment. Tuberk Bolezn Legk 4:55–56

    Google Scholar 

  • Berta M, Sturm G, Juri L, Cosiansi MC, Barzón S, Barnes AI, Rojo SC (2011) Bacteriological diagnosis of renal tuberculosis: an experience at the regional tuberculosis laboratory in Córdoba Province, Argentina. Rev Argent Microbiol 43(3):191–194

    PubMed  Google Scholar 

  • BlagodarnyĭIa A, Alimbekova OA, Blonskaia LI (1990) Characteristics of Mycobacteria from patients with genital tuberculosis. Probl Tuberk 1:37–41

    Google Scholar 

  • Bos JC, Smalbraak L, Macome AC, Gomes E, van Leth F, Prins JM (2013) TB diagnostic process management of patients in a referral hospital in Mozambique in comparison with the 2007 WHO recommendations for the diagnosis of smear-negative pulmonary TB and extrapulmonary TB. Int Health 5(4):302–308. doi:10.1093/inthealth/iht025

    Article  PubMed  Google Scholar 

  • Budía A, Luis Palmero J, Broseta E, Tejadillos S, Benedicto A, Queipo JA, Gobernado M, Fernando Jiménez Cruz J (2006) Value of semen culture in the diagnosis of chronic bacterial prostatitis: a simplified method. Scand J Urol Nephrol 40(4):326–331

    Article  PubMed  Google Scholar 

  • Buxi TB, Sud S, Vohra R (2002) CT and MRI in the diagnosis of tuberculosis. Indian J Pediatr 69(11):965–972

    Article  PubMed  CAS  Google Scholar 

  • Chapagain A, Dobbie H, Sheaff M, Yaqoob MM (2011) Presentation, diagnosis, and treatment outcome of tuberculous-mediated tubulointerstitial nephritis. Kidney Int 79(6):671–677

    Article  PubMed  CAS  Google Scholar 

  • Chawla A, Chawla K, Reddy S, Arora N, Bairy I, Rao S, Hegde P, Thomas J (2012) Can tissue PCR augment the diagnostic accuracy in genitourinary tract tuberculosis? Urol Int 88(1):34–38

    Article  PubMed  CAS  Google Scholar 

  • Christensen WI (1974) Genitourinary tuberculosis: review of 102 cases. Medicine (Baltimore) 53(5):377–390

    Article  CAS  Google Scholar 

  • Daher Ede F, Silva Júnior GB, Damasceno RT, Santos GM, Corsino GA, Silva SL, Gutiérrez-Adrianzén OA (2007) End-stage renal disease due to delayed diagnosis of renal tuberculosis: a fatal case report. Braz J Infect Dis 11(1):169–171

    Article  PubMed  Google Scholar 

  • Das KM, Indudhara R, Vaidyanathan S (1992a) Sonographic features of genitourinary tuberculosis. AJR Am J Roentgenol 158(2):327–329

    Article  PubMed  CAS  Google Scholar 

  • Das KM, Vaidyanathan S, Rajwanshi A, Indudhara R (1992b) Renal tuberculosis: diagnosis with sonographically guided aspiration cytology. AJR Am J Roentgenol 158(3):571–573

    Article  PubMed  CAS  Google Scholar 

  • Dumonceaux GA, St Leger J, Olsen JH, Burton MS, Ashkin D, Maslow JN (2011) Genitourinary and pulmonary multidrug resistant Mycobacterium tuberculosis infection in an Asian elephant (Elephasmaximus). J Zoo Wildl Med 42(4):709–712

    Article  PubMed  Google Scholar 

  • Eastwood JB, Corbishley CM, Grange JM (2011) Tuberculosis and tubulointerstitial nephritis: an intriguing puzzle. Kidney Int 79(6):579–581

    Article  PubMed  Google Scholar 

  • el Khader K, el Fassi J, Karmouni T, Tazi K, Ibnattya A, Hachimi M, Lakrissa A (1997) Urogenital tuberculosis. Apropos of 40 cases. Ann Urol (Paris) 31(6–7):339–343

    Google Scholar 

  • Figueiredo AA, Lucon AM, Arvellos AN, Ramos CO, Toledo AC, Falci R Jr, Gomes CM, Recaverren FE, Netto JM, Srougi M (2010) A better understanding of urogenital tuberculosis pathophysiology based on radiological findings. Eur J Radiol 76(2):246–257

    Article  PubMed  Google Scholar 

  • Golden MP, Vikram HR (2005) Extrapulmonary tuberculosis: an overview. Am Fam Physician 72(9):1761–1768

    PubMed  Google Scholar 

  • Grabe M, Bjerklund Johansen TE, Botto H, Wullt B, Cek M, Naber KG, Pickard RS, Tenke P, Wagenlehner F (2011) Guidelines on urological infections. European Association of Urology, Arnhem. ISBN 978-90-79754-96-0

    Google Scholar 

  • Hemal AK, Gupta NP, Rajeev TP, Kumar R, Dar L, Seth P (2000a) Polymerase chain reaction in clinically suspected genitourinary tuberculosis: comparison with intravenous urography, bladder biopsy, and urine acid fast bacilli culture. Urology 56(4):570–574

    Article  PubMed  CAS  Google Scholar 

  • Hemal AK, Gupta NP, Kumar R (2000b) Comparison of retroperitoneoscopic nephrectomy with open surgery for tuberculous nonfunctioning kidneys. J Urol 164(1):32–35

    PubMed  CAS  Google Scholar 

  • Kamyshan IS, Mams AN, Stepanov PI (2006) Capacities of rapid diagnostic methods in renal tuberculosis. Probl Tuberk Bolezn Legk (9):39–43. Review. Russian

    Google Scholar 

  • Kao SC, Fang JT, Tsai CJ, Chen KS, Huang CC (1996) Urinary tract tuberculosis: a 10-year experience. Chang Gung Med J 19(1):1–9

    CAS  Google Scholar 

  • Khakimov МА (2007) Organization of early detection of nephrotuberculosis on risk group. Probl Tuberk Bolezn Legk (9):44–46. Russian

    Google Scholar 

  • Kholtobin D, Kulchavenya E (2011a) Masks of kidney tuberculosis. ERS annual Congress, Amsterdam; Abstracts, 496s – P2693

    Google Scholar 

  • Kholtobin D, Kulchavenya E (2011b) The reasons for late diagnosis of nephrotuberculosis. ERS annual Congress, Amsterdam. 496s – P2694

    Google Scholar 

  • Kholtobin D, Kulchavenya E (2011c) Kidney tuberculosis in last century and now – is it the same disease? ERS annual Congress, Amsterdam. 496s – P2695

    Google Scholar 

  • Kim JK, Bang WJ, Oh CY, Yoo C, Cho JS (2013) Feasibility of the interferon-γ release assay for the diagnosis of genitourinary tuberculosis in an endemic area. Korean J Urol 54(2):123–126. doi:10.4111/kju.2013.54.2.123, Epub 2013 Feb 18

    Article  PubMed  PubMed Central  Google Scholar 

  • Kul’chavenia EV, Azizov AP, Brizhatiuk EV, Breusov, AA, Kholtobin DP (2011) A comparative study of efficacy of 2-, 3- and 4-glass tests in patients with chronic prostatitis. Urologiia (6):42–45

    Google Scholar 

  • Kulchavenya EV (2004) Difficulties of the diagnosis of urogenital tuberculosis. Yupiter, Novosibirsk, p 103

    Google Scholar 

  • Kulchavenya E (2009) Tuberculosis of urogenital system in urology: national manual. In: Lopatkin N (ed) Geotar-Media, Moscow, pp 584–601

    Google Scholar 

  • Kulchavenya E (2010) Some aspects of urogenital tuberculosis. Int J Nephrol Urol 2(2):351–360

    Google Scholar 

  • Kulchavenya EV, Krasnov VA (2010) Selected Issue of Phthysiourology (monograph). “Nauka” (“Science”), Novosibirsk. ISBN 978-5-02-023313-3

    Google Scholar 

  • Kwak N, Choi SM, Lee J, Park YS, Lee CH, Lee SM, Yoo CG, Kim YW, Han SK, Yim JJ (2013) Diagnostic accuracy and turnaround time of the Xpert MTB/RIF assay in routine clinical practice. PLoS One 8(10):e77456. doi:10.1371/journal.pone.0077456

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  • Lai CC, Tan CK, Lin SH, Liao CH, Huang YT, Wang CY, Wang JY, Lin HI, Hsueh PR (2010) Diagnostic value of an enzyme-linked immunospot assay for interferon-γ in genitourinary tuberculosis. Diagn Microbiol Infect Dis 68(3):247–250

    Article  PubMed  CAS  Google Scholar 

  • Lawn SD, Mwaba P, Bates M, Piatek A, Alexander H, Marais BJ, Cuevas LE, McHugh TD, Zijenah L, Kapata N, Abubakar I, McNerney R, Hoelscher M, Memish ZA, Migliori GB, Kim P, Maeurer M, Schito M, Zumla A (2013) Advances in tuberculosis diagnostics: the Xpert MTB/RIF assay and future prospects for a point-of-care test. Lancet Infect Dis 13(4):349–361. doi:10.1016/S1473-3099(13)70008-2, Epub 2013 Mar 24

    Article  PubMed  CAS  Google Scholar 

  • Lee KS, Choi JD (2012) Chronic prostatitis: approaches for best management. Korean J Urol 53:69–77

    Article  PubMed  PubMed Central  Google Scholar 

  • Lee Y, Huang W, Huang J, Wang J, Yu C, Jiaan B, Huang J (2001) Efficacy of chemotherapy for prostatic tuberculosis-a clinical and Histologic follow-up study. Urology 57(5):872–877

    Article  PubMed  CAS  Google Scholar 

  • Lenk S, Schroeder J (2001) Genitourinary tuberculosis. Curr Opin Urol 11(1):93–98

    Article  PubMed  CAS  Google Scholar 

  • Lenk S, Kalich R, Rothkopf M (1986) Detection of mycobacteria in tissue in urogenital tuberculosis. Z Urol Nephrol 79(12):709–16.39

    PubMed  CAS  Google Scholar 

  • Levashev YN, Mushkin AY, Grishko AN (2006) Extrapulmonary tuberculosis in Russia: official statistic and reality. Probl Tuberc Bolezn Legk 11:3–6

    Google Scholar 

  • Magri V, Wagenlehner FM, Montanari E, Marras E, Orlandi V, Restelli A, Torresani E, Naber KG, Perletti G (2009) Semen analysis in chronic bacterial prostatitis: diagnostic and therapeutic implications. Asian J Androl 11(4):461–477

    Article  PubMed  PubMed Central  Google Scholar 

  • McNauhgton-Collins M, Fowler FJ, Elliott DB, Albertsen PC, Barry MJ (2000) Diagnosing and treating chronic prostatitis: do urologists use the four-glass test? Urology 55:403–407

    Article  Google Scholar 

  • Meares EM Jr, Stamey TA (1968) Bacteriologic localization patterns in bacterial prostatitis and urethritis. Invest Urol 5:492

    PubMed  CAS  Google Scholar 

  • Mehta V, Mittal A, Bagga P, Singla M (2009) Two case reports of ultrasonography features in male genital tuberculosis. Indian J Tuberc 56(2):95–99

    PubMed  Google Scholar 

  • Merchant S, Bharati A, Merchant N (2013) Tuberculosis of the genitourinary system – urinary tract tuberculosis: renal tuberculosis-part I. Indian J Radiol Imaging 23(1):46–63. doi:10.4103/0971-3026.113615

    Article  PubMed  PubMed Central  Google Scholar 

  • Mesquita M, Libertalis M, Bakoto ES et al (2010) Late diagnosis of extra-pulmonary tuberculosis leads to irreversible kidney failure in a non-immunocompromised patient. Int Urol Nephrol 42(1):227–232

    Article  PubMed  Google Scholar 

  • Millman AJ, Dowdy DW, Miller CR, Brownell R, Metcalfe JZ, Cattamanchi A, Davis JL (2013) Rapid molecular testing for TB to guide respiratory isolation in the U.S.: a cost-benefit analysis. PLoS One 8(11):e79669. doi:10.1371/journal.pone.0079669

    Article  PubMed  PubMed Central  Google Scholar 

  • Moon TD (1997) Questionnaire survey of urologists and primary care physicians’ diagnostic and treatment practices for prostatitis. Urology 50:543–547

    Article  PubMed  CAS  Google Scholar 

  • Moussa OM, Eraky I, El-Far MA, Osman HG, Ghoneim MA (2000) Rapid diagnosis of genitourinary tuberculosis by polymerase chain reaction and non-radioactive DNA hybridization. J Urol 164(2):584–588

    PubMed  CAS  Google Scholar 

  • Muttarak M, ChiangMai WN, Lojanapiwat B (2005) Tuberculosis of the genitourinarytract: imaging features with pathological correlation. Singapore Med J 46(10):568–574

    PubMed  CAS  Google Scholar 

  • Nickel J (2003) Recommendations for the evaluation of patients with prostatitis. World J Urol 21(2):75–81

    Article  PubMed  Google Scholar 

  • Nickel JC, Weidner W (2000) Chronic prostatitis: current concepts and antimicrobial therapy. Infect Urol 13(5A):s22–s28

    Google Scholar 

  • Nickel JC, Shoskes D, Wang Y, Alexander RB, Fowler JE Jr, Zeitlin S, O’Leary MP, Pontari MA, Schaeffer AJ, Landis JR, Nyberg L, Kusek JW, Propert KJ (2006) How does the pre-massage and post-massage 2-glass test compare to the Meares-Stamey 4-glass test in men with chronic prostatitis/chronic pelvic pain syndrome? J Urol 176(1):119–124

    PubMed  Google Scholar 

  • Peter JG, Theron G, Muchinga TE, Govender U, Dheda K (2012) The diagnostic accuracy of urine-based Xpert MTB/RIF in HIV-infected hospitalized patients who are smear-negative or sputum scarce. PLoS One 7:e39966

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  • Premkumar A, Lattimer J, Newhouse JH (1987) CT and sonography of advanced urinary tract tuberculosis. AJR Am J Roentgenol 148(1):65–69

    Article  PubMed  CAS  Google Scholar 

  • Siatelis A, Houhoula DP, Papaparaskevas J, Delakas D, Tsakris A (2011) Detection of bacillus Galmette-Guérin (Mycobacterium bovis BCG) DNA in urine and blood specimens after intravesical immunotherapy for bladder carcinoma. J Clin Microbiol 49(4):1206–1208

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  • Sigaev AT, Batyrov FA, Rahmatullin PP, Nersesyan AA (2009) Functional condition of kidneys on radio-isotope examination. Probl Tuberk Bolezn Legk 11:36–39

    Google Scholar 

  • Singh DD, Vogel M, Müller-Stöver I, El Scheich T, Winzer M, Göbels S, Hüttig F, Heinrich S, Mackenzie C, Jensen B, Reuter S, Häussinger D, Richter J (2011a) TB or not TB? Difficulties in the diagnosis of tuberculosis in HIV-negative immigrants to Germany. Eur J Med Res 16(9):381–384

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  • Singh V, Sinha RJ, Sankhwar SN, Sinha SM (2011b) Reconstructive surgery for tuberculous contracted bladder: experience of a center in northern India. Int Urol Nephrol 43(2):423–430

    Article  PubMed  Google Scholar 

  • Stepanshina VN, Panfertsev EA, Mitrofanova GN, Korobova OV, Stepanshin IuG, Shemiakin IG, Medvedeva IM (2000) Molecular mechanisms of mycobacterium tuberculosis strains resistance to rifampicin and isoniazid. Probl Tuberk (1):32–36. Russian

    Google Scholar 

  • Sun L, Yuan Q, Feng JM, Yang CM, Yao L, Fan QL, Liu LL, Ma JF, Wang LN (2010) Rapid diagnosis in early stage renal tuberculosis by real-time polymerase chain reaction on renal biopsy specimens. Int J Tuberc Lung Dis 14(3):341–346

    PubMed  CAS  Google Scholar 

  • Sun L, Yuan Q, Feng J, Yao L, Fan Q, Ma J, Wang L (2012) Be alert to tuberculosis-mediated glomerulonephritis: a retrospective study. Eur J Clin Microbiol Infect Dis 31(5):775–779

    Article  PubMed  CAS  Google Scholar 

  • Szomor L, Zillich P (1973) The diagnostic value of isotope renography in renal tuberculosis. Int Urol Nephrol 5(2):153–161

    Article  PubMed  CAS  Google Scholar 

  • Tanthanuch M, Karnjanawanichkulm W, Pripatnanont C (2010) Tuberculosis of the urinary tract in southern Thailand. J Med Assoc Thai 93(8):916–919

    PubMed  Google Scholar 

  • Tortoli E, Russo C, Piersimoni C, Mazzola E, Dal Monte P, Pascarella M, Borroni E, Mondo A, Piana F, Scarparo C, Coltella L, Lombardi G, Cirillo DM (2012) Clinical validation of Xpert MTB/RIF for the diagnosis of extrapulmonary tuberculosis. Eur Respir J 40:442–447

    Article  PubMed  Google Scholar 

  • Vourganti S, Agarwal PK, Bodner DR, Dogra VS (2006) Ultrasonographic evaluation of renal infections. Radiol Clin North Am 44(6):763–775

    Article  PubMed  Google Scholar 

  • Walusimbi S, Bwanga F, De Costa A, Haile M, Joloba M, Hoffner S (2013) Meta-analysis to compare the accuracy of GeneXpert, MODS and the WHO 2007 algorithm for diagnosis of smear-negative pulmonary tuberculosis. BMC Infect Dis 13(1):507

    Article  PubMed  PubMed Central  Google Scholar 

  • Wang LJ, Wong YC, Chen CJ, Lim KE (1997a) CT features of genitourinary tuberculosis. J Comput Assist Tomogr 21(2):254–258

    Article  PubMed  CAS  Google Scholar 

  • Wang JH, Sheu MH, Lee RC (1997b) Tuberculosis of the prostate: MR appearance. J Comput Assist Tomogr 21(4):639–640

    Article  PubMed  CAS  Google Scholar 

  • Webster D, Long R, Shandro C, Pettipas J, Leblanc J, Davidson R, Fanning A (2010) Fluoroquinolone resistance in renal isolates of Mycobacterium tuberculosis. Int J Tuberc Lung Dis 14(2):217–222

    PubMed  CAS  Google Scholar 

  • Weyer K, Mirzayev F, Migliori GB, Van Gemert W, D’Ambrosio L, Zignol M, Floyd K, Centis R, Cirillo DM, Tortoli E, Gilpin C, de Dieu Iragena J, Falzon D, Raviglione M (2012) Rapid molecular TB diagnosis: evidence, policy-making and global implementation of Xpert(R)MTB/RIF. Eur Respir J 42(1):252–271. doi:10.1183/09031936.00157212, Epub 2012 Nov 22

    Article  PubMed  Google Scholar 

  • Zarrabi AD, Heyns CF (2009) Clinical features of confirmed versus suspected urogenital tuberculosis in region with extremely high prevalence of pulmonary tuberculosis. Urology 74(1):41–45

    Article  PubMed  CAS  Google Scholar 

  • Zhang L, Xu W, Cui Z, Liu Y, Wang W, Wang J, Hu D, Liu D, Wang H (2013) A novel method of identifying Mycobacterium tuberculosis Beijing Strains by Detecting SNPs in Rv0444c and Rv2629. Curr Microbiol [Epub ahead of print]

    Google Scholar 

  • Zhuravlev VN, Golubev DN, Novikov BI, Skorniakov SN, Medvinskiĭ ID, Arkanov LV, Cherniaev IA, Borodin ÉP, Verbetskiĭ AF, Bobykin EN (2012) Particular features of detection of patients with urogenital tuberculosis and their management. Urologiia (1):11–15

    Google Scholar 

  • Zümrütdal A, Yıldız I, Ozelsancak R, Canpolat T (2011) Chronic renal failure: unexpected late sequela of pulmonary tuberculosis after 30 years. Mikrobiyol Bul 45(2):366–370

    PubMed  Google Scholar 

  • Kumar V, Jha V, Sakhuja V (2012) Putty kidney. Iranian J Kidney Dis 6(4):255

    Google Scholar 

  • Done, J.D., Rudick, C.N., Quick, M.L., Schaeffer, A.J. & Thumbikat, P. (2012). Role of mast cells in male chronic pelvic pain. J Urol. [Epub ahead of print]

    PubMed  PubMed Central  Google Scholar 

  • Thangappah, R.B., Paramasivan, C.N., & Narayanan, S. (2011). The Indian journal of medical research. July;134:40-6

    CAS  Google Scholar 

  • Maclean KA, Becker AK, Chang SD, Harris AC (2012) Extrapulmonary tuberculosis: imaging features beyond the chest. Can Assoc Radiol J. doi:10.1016/j.carj.2012.07.002, pii: S0846-5371(12)00090-3 [Epub ahead of print]

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Kulchavenya, E. (2014). Diagnostic of Urogenital Tuberculosis. In: Urogenital Tuberculosis: Epidemiology, Diagnosis, Therapy. Springer, Cham. https://doi.org/10.1007/978-3-319-04837-6_5

Download citation

Publish with us

Policies and ethics