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Biopsy-confirmed Genitourinary Tuberculosis in a Secondary Health Care Hospital: An Evidence-based Clinical Review

Authors Prihadi JC, Putra AC, Wahyudi Y

Received 11 November 2020

Accepted for publication 8 February 2021

Published 17 March 2021 Volume 2021:13 Pages 133—137


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Jan Colli

Johannes Cansius Prihadi,1,2 Andika Chandra Putra,3,4 Yuvi Wahyudi2

1Department of Surgery, Urology Division, School of Medicine and Health Sciences, Atma Jaya Catholic University, Jakarta, Indonesia; 2Department of Urology, St. Carolus Hospital, Jakarta, Indonesia; 3Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; 4Department of Pulmonology and Respiratory Medicine, St. Carolus Hospital, Jakarta, Indonesia

Correspondence: Johannes Cansius Prihadi
Department of Surgery, Urology Division, School of Medicine and Health Sciences, Atma Jaya Catholic University, Jl. Pluit Selatan Raya No. 19, RT.21/RW.8, Penjaringan, Kec. Penjaringan, Kota Jkt Utara, Daerah Khusus Ibukota, Jakarta, 14440, Indonesia
Tel +62 21 6694366
Email [email protected]

Introduction: Tuberculosis (TB) is a worldwide disease and remains a major public health problem in developing countries, with 95% of cases occurring in developing countries, including Indonesia. It is caused by Mycobacterium tuberculosis, an acid-fast aerobic bacillus. When M. tuberculosis infects other than lung, it is called extrapulmonary tuberculosis (EPTB). Among other organs, genitourinary tuberculosis (GUTB) is responsible for 30– 40% of all EPTB cases.
Methods: The study was conducted in a secondary health-care hospital in central Jakarta over a five-year period. We took data from hospital’s medical records and collected all the positive histopathological reports on biopsied tissue of the genitourinary tract from 2014– 2019.
Results: Eleven patients showed positive histopathological results for TB on their biopsied genitourinary tissue. The genitourinary tracts involved were as follows: prostate (n=2), kidney (n=1), ureter (n=2), epididymis (n=1), epididymo-orchitis (n=1), bladder (n=4). All of them presented with specific genitourinary symptoms, such as lower urinary tract symptoms (LUTS) (n=8), dysuria (n=9), urinary retention (n=2), flank pain (n=6), and incontinence (n=1). Nine of 11 patients (81.8%) exhibited systemic manifestations, with fever being the most common (n=8), followed by malaise (n=6), dyspepsia syndrome (n= 4), and weight loss (n=3).
Discussion: Consistent with other studies, our research found that the prevalence of GUTB is substantially decreased with advancing age. Kidney is the most common site infected in GUTB infection. GUTB is easily overlooked, because its signs and symptoms are usually typical of a conventional bacterial cystitis.
Conclusion: Because of its insidious nature and late-onset symptoms, diagnosis of GUTB is often late to approach, leading to higher morbidity and even mortality rate. This leads into further complications of the disease, which are largely preventable by a correct and timely diagnosis followed by appropriate therapy.

Keywords: tuberculosis, genitourinary, extrapulmonary

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