Tuberculosis of the genitourinary system: Root causes, symptoms, and prognosis
Genitourinary tuberculosis (GUTB) is a type of tuberculosis that affects the genitals or urinary tract. This less common form of TB is caused by the same bacteria responsible for pulmonary and extrapulmonary tuberculosis - Mycobacterium tuberculosis.
Causes and Transmission
The primary cause of GUTB is infection by Mycobacterium tuberculosis bacteria, often secondary dissemination from pulmonary or other extrapulmonary sites. The bacteria can spread through the body via the bloodstream, lymphatics, or direct extension from adjacent infected tissues.
While rare, GUTB can also be sexually transmitted between partners if active genital lesions are present.
Risk factors for GUTB include immunosuppression, latent TB infection turning active, and delayed diagnosis leading to progression.
Symptoms in Both Males and Females
GUTB presents with a combination of local symptoms related to urinary and genital tract involvement and systemic signs of tuberculosis infection.
Common symptoms include increased frequency, urgency of urination, painful urination (dysuria), and hematuria (blood in urine). Flank or pelvic pain is also common due to involvement of kidneys, ureters, bladder, or reproductive organs.
General symptoms such as fever, chills, night sweats, weight loss, fatigue, and malaise can be present, reflecting systemic infection.
Male-specific symptoms may include scrotal pain, swelling, or lesions due to involvement of testes, epididymis, seminal vesicles, or ductus deferens. Female-specific symptoms may include genital involvement, causing menstrual irregularities, pelvic pain, infertility, and endometrial tuberculosis symptoms.
Complications
Delayed diagnosis can lead to ureteric strictures, renal damage, infertility, or non-functioning kidneys. In severe cases, surgical intervention may be necessary.
Diagnosis and Treatment
Diagnosis of GUTB can be challenging due to its ability to affect any part of the genitourinary system and the broad variation in symptoms. The gold standard for diagnosis involves detecting M. tuberculosis in body samples such as urine, pus, prostate massage fluid in males, discharge fluid, and biopsy. Imaging tests and blood tests are also diagnostic tools.
With early detection and prompt standard medication treatment, the cure rate for GUTB is high. However, relapses may still occur in some cases after an average of 5.3 years following treatment.
The treatment for GUTB typically consists of a 6-month medication regimen, starting with 2 months of rifampicin, ethambutol, isoniazid, and pyrazinamide, followed by 4 months of rifampicin and isoniazid. In some cases, the use of corticosteroids may be necessary to prevent worsening of strictures in the ureter.
In circumstances where surgical intervention is necessary, such as kidney cancer or extensive kidney damage, surgical removal of a kidney may be required. Renal transplantation may also be an option for those with GUTB and kidney damage who are receiving or have received antituberculosis therapy.
It's important to note that in rare cases, the tuberculosis vaccine bacillus Calmette-Guérin can lead to GUTB.
In conclusion, early recognition and treatment of GUTB are crucial to avoid irreversible damage such as kidney failure or infertility. With proper diagnosis and treatment, the prognosis for those with GUTB is generally good.
- Despite being less common, urostomy can be a consequence of chronic kidney disease resulting from genitourinary tuberculosis (GUTB).
- Science has made advancements in therapies and treatments for medical conditions like breast cancer, but it also plays a critical role in managing the chronic diseases associated with urostomy, such as GUTB.
- Respiratory conditions like tuberculosis can present serious health-and-wellness issues, with Mycobacterium tuberculosis being the bacteria responsible for both pulmonary and urinary health complications like GUTB.
- Researchers are exploring new avenues for managing and treating chronic-diseases such as GUTB, with a focus on reducing the risk of complications like ureteric strictures or renal damage.
- In light of urostomy being a possible outcome for patients with advanced GUTB, health-and-wellness practitioners emphasize maintaining a strong understanding of the medical-conditions and chronic-diseases related to the urinary tract, including GUTB.
